NPIMap

Individual provider Active NPI

Kristina Lee Smith, DO

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1760742282
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5442 Issued in OK
Practice address
9645 Riverside Pkwy Ste C
Tulsa, OK 74137-7427
Phone
(918) 209-5170
Fax
(918) 209-5187
NPI assigned
May 17, 2012
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5442 OK Primary

Addresses

Primary practice location

9645 Riverside Pkwy Ste C
Tulsa, OK 74137-7427

Mailing address

9645 Riverside Pkwy Ste C
Tulsa, OK 74137-7427
Phone (918) 209-5170

Other identifiers 2

IdentifierTypeStateIssuer
200494810BMedicaidOK
747279OtherOKMEDICARE

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
I20151228001052 OK Practitioner - Internal Medicine 3375844962 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians

Practice addresses (Care Compare)

042 Murray
Stillwater, OK 74078-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
77.78
Promoting interoperability
99
Improvement activities
40
Cost
73.95

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 19, 2021 Accepting new patients
McAlester Medical Services, LLC Internal Medicine CurrentSince Apr 28, 2022 Accepting new patients
Oklahoma State University CurrentSince Dec 4, 2023 Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Jul 19, 2021 Accepting new patients
Cleveland Area Hospital Holdings, Inc. CurrentSince Jan 5, 2024 Accepting new patients
Oklahoma State University CurrentSince Dec 4, 2023 Accepting new patients
Cleveland Area Hospital Holdings, Inc. CurrentSince Jan 5, 2024 Accepting new patients
Oklahoma State University Internal Medicine Past Accepting new patients

Locations

1401 W Pawnee St
Cleveland, OK 74020
Phone (918) 358-2501

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

1 E Clark Bass Blvd
#H
McAlester, OK 74501
Phone (918) 421-6941

2 E Clark Bass Blvd
Ste 301
McAlester, OK 74501
Phone (918) 421-6834

4 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6700

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

9645 Riverside Pkwy
Ste C
Tulsa, OK 74137
Phone (918) 209-5170

Dept 2563
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: ksmith714536@directa.mercy.net
  • Direct secure messaging: ksmith86416@direct.saintfrancis.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1760742282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 RIVERSIDE PKWY STE C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377427",
            "telephone_number": "918-209-5170",
            "fax_number": "918-209-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 RIVERSIDE PKWY STE C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377427",
            "telephone_number": "918-209-5170",
            "fax_number": "918-209-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTINA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200494810B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "747279",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.