Individual provider Active NPI

Elizabeth Trigalet Bader, D.O.

  • Pediatrics Physician
  • Owasso, OK
National Provider Identifier
1790940500
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4738 Issued in OK
Practice address
12150 E 96TH St N Ste 101
Owasso, OK 74055-5339
Phone
(918) 716-5437
Fax
(539) 202-5020
NPI assigned
Jul 21, 2008
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4738 OK Primary

Addresses

Primary practice location

12150 E 96TH St N Ste 101
Owasso, OK 74055-5339

Mailing address

12150 E 96TH St N Ste 101
Owasso, OK 74055-5339
Phone (918) 716-5437

Other practice location 1

5795 S Elm Pl
Broken Arrow, OK 74011-4893
Phone (918) 716-5437

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
I20131031001299 OK Practitioner - Pediatric Medicine 3577798495 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC CurrentSince Dec 1, 2014 Accepting new patients
On Call Pediatrics PLLC Pediatrics CurrentSince Mar 24, 2024 Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

5795 S Elm Pl
Broken Arrow, OK 74011
Phone (918) 716-5437

12939 E 116th St N
Collinsville, OK 74021
Phone (918) 716-5437

12150 E 96th St N
Ste 101
Owasso, OK 74055
Phone (918) 716-5437

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790940500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 E 96TH ST N STE 101",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555339",
            "telephone_number": "918-716-5437",
            "fax_number": "539-202-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 E 96TH ST N STE 101",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555339",
            "telephone_number": "918-716-5437",
            "fax_number": "539-202-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5795 S Elm Pl",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740114893",
            "country_code": "US",
            "telephone_number": "918-716-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADER",
        "first_name": "ELIZABETH",
        "middle_name": "TRIGALET",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "4738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.