Individual provider Active NPI

Matthew Dean Tucker, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1760473995
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3498 Issued in OK
Practice address
1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Phone
(918) 748-7557
Fax
(918) 403-0383
NPI assigned
Nov 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3498 OK Primary

Addresses

Primary practice location

1717 S Utica Ave Ste a
Tulsa, OK 74104-5346

Mailing address

1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Phone (918) 748-7557

Other identifiers 2

IdentifierTypeStateIssuer
100119850AMedicaidOK
930087699OtherOKRAILROAD MEDICARE

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
I20060301000416 OK Practitioner - Emergency MedicinePractitioner - General Practice 1153337092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3498OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Sep 4, 2024 Accepting new patients
Sterling Emergency Services of Oklahoma, Inc. Emergency Medicine Past Accepting new patients
True Believers Family Clinic PLLC PastSince Jun 29, 2025 Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

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

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

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

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1760473995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "918-748-7557",
            "fax_number": "918-403-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MATTHEW",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "3498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100119850A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930087699",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.