Individual provider Active NPI

Liphard O D'Souza, MD

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Tulsa, OK
National Provider Identifier
1790729150
Registry record updated Nov 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
15158 Issued in OK
Practice address
4157 S Harvard Ave
Suite 130
Tulsa, OK 74135-2631
Phone
(918) 296-0596
Fax
(918) 296-0596
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 15158 OK Primary

Addresses

Primary practice location

4157 S Harvard Ave
Suite 130
Tulsa, OK 74135-2631

Mailing address

PO Box 701353
Tulsa, OK 74170-1353
Phone (918) 296-0596

Other identifiers 4

IdentifierTypeStateIssuer
100379610BMedicaidKS
0599597MedicaidIA
100008970AMedicaidOK
100008970BMedicaidOK

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
I20050531000666 OK Practitioner - NeurologyPractitioner - Pediatric MedicinePractitioner - Other (Physician)Practitioner - Sleep Medicine 0840232856 Reassigns benefits to 1 organization
Practice locations: Tulsa, OK

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine, Sleep Medicine
Education
Other, 1971
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3020 S Harvard Ave
Suite 100
Tulsa, OK 74114-6136
Phone (918) 296-0596

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro Dynamics LLC CurrentSince Nov 15, 2016 Accepting new patients
L and M Investments LLC CurrentSince Jan 1, 2021 Accepting new patients
Neuropathy Treatment Clinic of Oklahoma LLC CurrentSince Feb 1, 2019 Accepting new patients
Jane Phillips Memorial Medical Center Inc Past Accepting new patients
JP Sleep Disorders LLC PastSince Nov 16, 2007 Accepting new patients
Oklahoma Sleep Specialists LLC Past Accepting new patients
Neurologic Services of Oklahoma LLC Past Accepting new patients

Locations

234 SE Debell Ave
Bartlesville, OK 74006
Phone (918) 574-6470

6001 NW 139th St
Oklahoma City, OK 73142
Phone (405) 271-4646

22 S Lewis Ave
Tulsa, OK 74104
Phone (918) 770-9333

1810 E 15th St
Tulsa, OK 74104
Phone (918) 499-2000

4636 S Harvard Ave
Ste 102
Tulsa, OK 74135
Phone (918) 574-6470

Organizations & group practices 7

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414886400000",
    "number": "1790729150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701353",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741701353",
            "telephone_number": "918-296-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 S HARVARD AVE",
            "address_2": "SUITE 130",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352631",
            "telephone_number": "918-296-0596",
            "fax_number": "918-296-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'SOUZA",
        "first_name": "LIPHARD",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "OK",
            "license": "15158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100379610B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0599597",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100008970A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100008970B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.