Individual provider Active NPI

Brent C Nossaman, D.O.

  • Orthopaedic Surgery Physician
  • Tulsa, OK
National Provider Identifier
1720048945
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3041 Issued in OK
Practice address
2448 E 81St St Ste 1300
Tulsa, OK 74137-4305
Phone
(918) 550-8950
Fax
(918) 550-8952
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 3041 OK
Orthopaedic Surgery Physician 207X00000X 3041 OK Primary

Addresses

Primary practice location

2448 E 81St St Ste 1300
Tulsa, OK 74137-4305

Mailing address

2448 E 81St St Ste 1300
Tulsa, OK 74137-4305
Phone (918) 550-8950

Other identifiers 1

IdentifierTypeStateIssuer
100195130AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000763 OK Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 9537168315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2448 E 81St St
Suite 1300
Tulsa, OK 74137-4305
Phone (918) 550-8950

Hospital & facility affiliations

  • Oklahoma Surgical Hospital, LLC Hospital, Tulsa, OK, CCN 370210

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)28
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3041OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Extremity Orthopedic Specialists PLLC Orthopaedic Surgery CurrentSince Jul 1, 2020 Accepting new patients
Osu Health System Anesthesia Past Accepting new patients

Locations

2448 E 81st St
Ste 1520
Tulsa, OK 74137
Phone (918) 481-2767

2448 E 81st St
Ste 1300
Tulsa, OK 74137
Phone (918) 524-0080

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oklahoma Surgical Hospital LLCTulsa, OK, CCN 370210 Hospital General Partnership Interest (1.39%) Apr 30, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1720048945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 E 81ST ST STE 1300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374305",
            "telephone_number": "918-550-8950",
            "fax_number": "918-550-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 E 81ST ST STE 1300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374305",
            "telephone_number": "918-550-8950",
            "fax_number": "918-550-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSSAMAN",
        "first_name": "BRENT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OK",
            "license": "3041",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "3041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100195130A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.