Individual provider Active NPI

Stephen Joseph Brasseux, M.D.

  • Psychiatry Physician
  • Tulsa, OK
National Provider Identifier
1790867687
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E-6485 Issued in AR
Practice address
5310 E 31St St FL LL
Tulsa, OK 74135-5018
Phone
(918) 236-4000
Fax
(918) 236-4001
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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 E-6485 AR Primary

Addresses

Primary practice location

5310 E 31St St FL LL
Tulsa, OK 74135-5018

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
200788050AMedicaidOK
704532OtherOKMEDICARE

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
I20180917000405 OK Practitioner - Psychiatry 5193863066 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28995SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Oklahoma State University Psychiatry CurrentSince Jan 1, 2020 Accepting new patients

Locations

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

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

2401 Southwest Blvd
Tulsa, OK 74107

2323 S Harvard Ave
Tulsa, OK 74114
Phone (918) 293-2140

2448 E 81st St
Ste 2000
Tulsa, OK 74137
Phone (918) 236-4000

Dept 2563
Tulsa, OK 74182

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

5310 E 31st St
Ste Ll
Tulsa, OK 74135
Phone (918) 236-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1790867687",
    "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 FL LL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-236-4000",
            "fax_number": "918-236-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSEUX",
        "first_name": "STEPHEN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-6485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200788050A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "704532",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.