NPIMap

Organization Active NPI

Oklahoma State University

Doing business as Osu Physicians

  • Medical Specialty Clinic/Center
  • Tulsa, OK
National Provider Identifier
1780321893
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
OKLAHOMA STATE UNIVERSITY
Doing business as
Osu Physicians
Practice address
5310 E 31St St Ste 1102
Tulsa, OK 74135-5018
Phone
(918) 561-1890
Fax
(918) 561-1889
NPI assigned
May 19, 2022
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OKLAHOMA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Eric John Polak
Title
VP Administrative Affairs
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

5310 E 31St St Ste 1102
Tulsa, OK 74135-5018

Mailing address

5310 E 31St St FL 13
Tulsa, OK 74135-5018
Phone (918) 561-5701

Other names 2

  • OSU PHYSICIANS Doing business as
  • OSU Addiction Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University221 organizations share this tax ID, including this one
Part of
Oklahoma State University

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5310 E 31st St
Ste 1102
Tulsa, OK 74135
Phone (918) 561-1890

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1780321893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST FL 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 1102",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-561-1890",
            "fax_number": "918-561-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OKLAHOMA STATE UNIVERSITY",
        "enumeration_date": "2022-05-19",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VP ADMINISTRATIVE AFFAIRS",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OSU PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OSU Addiction Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.