Individual provider Active NPI

McKenzie Christine Peet

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1790336642
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4703 Issued in OK
Practice address
1145 S Utica Ave
Tulsa, OK 74104-4000
Phone
(918) 579-3130
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4703 OK Primary

Addresses

Primary practice location

1145 S Utica Ave
Tulsa, OK 74104-4000

Mailing address

1145 S Utica Ave Ste 110
Tulsa, OK 74104-4013
Phone (918) 579-3825

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211221000178 OK Practitioner - Physician Assistant 9537550801 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Hospital Medicine Physicians Group, LLCGroup PAC ID 7214327832, 132 clinicians
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians
Ahs Claremore Regional Hospital LLCGroup PAC ID 4284809278, 31 clinicians

Practice addresses (Care Compare)

10502 N 110TH E Ave
Bailey Medical Center
Owasso, OK 74055-6655
Phone (918) 579-2300

10512 N 110TH E Ave
Owasso, OK 74055-6638

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-9393

1202 N Muskogee PL
Claremore, OK 74017-3058
Phone (918) 341-2556

1501 N Florence Ave
Suite 101 201 250 and 300
Claremore, OK 74017-3179
Phone (918) 579-3627

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

8801 S 101St E Ave
Tulsa, OK 74133-5716
Phone (918) 294-4000

8803 S 101St E Ave
Suite 385
Tulsa, OK 74133-5779
Phone (918) 250-2033

Hospital & facility affiliations

  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
  • Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
  • Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228
  • Hillcrest Hospital Cushing Hospital, Cushing, OK, CCN 370099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4703OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Physician Assistant CurrentSince Dec 15, 2021 Accepting new patients

Locations

1501 N Florence Ave
Ste 201
Claremore, OK 74017
Phone (918) 341-1886

1501 N Florence Ave
Ste 101
Claremore, OK 74017
Phone (918) 341-4532

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1301 NE 1st St
Pryor, OK 74361
Phone (918) 824-6407

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1145 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-2368

1145 S Utica Ave
Ste 202
Tulsa, OK 74104
Phone (918) 560-3838

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

1120 S Utica Ave
#G100
Tulsa, OK 74104
Phone (918) 392-0175

Dept 1206
Tulsa, OK 74182

1809 E 13th St
Ste 300
Tulsa, OK 74104
Phone (918) 809-0575

8803 S 101st East Ave
Ste 130
Tulsa, OK 74133
Phone (918) 459-0027

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: mlloyd493570@ahs.direct-ci.com

Organizations & group practices 3

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 5

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1790336642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-579-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEET",
        "first_name": "MCKENZIE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.