Individual provider Active NPI

Andre Fallot, MD

  • Pediatric Critical Care Medicine Physician
  • Tulsa, OK
National Provider Identifier
1730158213
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
40275 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 502-6135
Fax
(918) 502-6137
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 60051227 WA
Pediatric Pulmonology Physician 2080P0214X 60051227 WA
Pediatric Critical Care Medicine Physician 2080P0203X 40275 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111227000808 WA Practitioner - Pediatric MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7517133473 Reassigns benefits to 1 organization
I20221228000994 OK Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 7517133473 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60051227WAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Sep 24, 2019 Accepting new patients
Warren Clinic Inc CurrentSince Jan 18, 2023 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: afallot279642@direct.saintfrancis.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1730158213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-502-6135",
            "fax_number": "918-502-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLOT",
        "first_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WA",
            "license": "60051227",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "WA",
            "license": "60051227",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OK",
            "license": "40275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.