NPIMap

Individual provider Active NPI

Mickey R Tyrrell, MD

  • Family Medicine Physician
  • Vinita, OK
National Provider Identifier
1710925680
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22897 Issued in OK
Practice address
803 N Foreman St
Suite 102
Vinita, OK 74301-1412
Phone
(918) 256-2261
Fax
(918) 256-2304
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22897 OK Primary

Addresses

Primary practice location

803 N Foreman St
Suite 102
Vinita, OK 74301-1412

Mailing address

803 N Foreman St
Suite 102
Vinita, OK 74301-1412
Phone (918) 256-2261

Other identifiers 1

IdentifierTypeStateIssuer
200056320BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107000550 OK Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Obstetrics/GynecologyPractitioner - Allergy/Immunology 7618909383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr.Mickey Tyrrell, M.D. PLLCGroup PAC ID 6204856552, 2 clinicians

Practice addresses (Care Compare)

803 N Foreman St
Vinita, OK 74301-1435

Hospital & facility affiliations

  • Via Life Home Health Care Home health agency, Pryor, OK, CCN 377689
  • Carter Healthcare of Oklahoma, LLC Home health agency, Vinita, OK, CCN 377692
  • Elara Caring XXV Home health agency, Tulsa, OK, CCN 377667
  • Enhabit Home Health of Northeast Oklahoma Home health agency, Broken Arrow, OK, CCN 377572
  • Amedisys Home Health Home health agency, Grove, OK, CCN 377072
  • Vialife Hospice LLC Hospice, Pryor, OK, CCN 371720
  • Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Heartsworth Center For Nursing & Rehabilitation Nursing home, Vinita, OK, CCN 375493
  • Saint Francis Hospital Vinita, Inc Nursing home, CCN 37U237

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22897OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr.Mickey Tyrrell, M.D. PLLC Family Medicine CurrentSince Sep 1, 2005 Accepting new patients
Ies ER Oklahoma LLC CurrentSince Oct 1, 2025 Accepting new patients
Heartsworth Operations SNF LLC Past Accepting new patients
Saint Francis Hospital Vinita, Inc Past Accepting new patients

Locations

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

803 N Foreman St
Vinita, OK 74301
Phone (918) 256-2257

735 N Foreman St
Vinita, OK 74301
Phone (918) 256-7551

803 N Foreman St
Ste 102
Vinita, OK 74301
Phone (918) 256-2257

Interoperability endpoints

  • Direct secure messaging: tyrrellm@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFCAA/Endpoint/HBFCAA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1710925680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 N FOREMAN ST",
            "address_2": "SUITE 102",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743011412",
            "telephone_number": "918-256-2261",
            "fax_number": "918-256-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 N FOREMAN ST",
            "address_2": "SUITE 102",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743011412",
            "telephone_number": "918-256-2261",
            "fax_number": "918-256-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRRELL",
        "first_name": "MICKEY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "22897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200056320B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

Verify at the official NPI Registry.