Individual provider Active NPI

Bradley Allen McClure, MD

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1790755916
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
24252 Issued in OK
Practice address
6135 S 90TH East Ave
Tulsa, OK 74133-6365
Phone
(539) 367-1145
Fax
(539) 367-1224
NPI assigned
Jan 23, 2006
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 24252 OK Primary

Addresses

Primary practice location

6135 S 90TH East Ave
Tulsa, OK 74133-6365

Mailing address

6135 S 90TH East Ave
Tulsa, OK 74133-6365
Phone (539) 367-1145

Other identifiers 3

IdentifierTypeStateIssuer
2241877OtherCIGNA BEHAVIORAL HEALTH
7099685OtherAETNA BEHAVIORAL HEALTH
200056450AMedicaidOK

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
I20050823000045 OK Practitioner - Psychiatry 2365478104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 2001
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
McClure and Associates Psychiatry PLLCGroup PAC ID 6406297415, 6 clinicians

Practice addresses (Care Compare)

6135 S 90TH E Ave
Tulsa, OK 74133-6365
Phone (539) 367-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24252OKMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McClure & Associates Psychiatry PLLC Psychiatry CurrentSince Mar 24, 2024 Accepting new patients

Locations

6135 S 90th East Ave
Tulsa, OK 74133
Phone (539) 367-1145

Organizations & group practices 2

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1790755916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 S 90TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336365",
            "telephone_number": "539-367-1145",
            "fax_number": "539-367-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 S 90TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336365",
            "telephone_number": "539-367-1145",
            "fax_number": "539-367-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "24252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2241877",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "7099685",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200056450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.