Individual provider Active NPI

Kevin Paul Kunkel, MD

  • Plastic Surgery Physician
  • Tulsa, OK
National Provider Identifier
1801937370
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
23427 Issued in OK
Practice address
6465 S Yale Ave
Suite 811
Tulsa, OK 74136-7823
Phone
(918) 502-7175
Fax
(918) 502-7180
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 23427 OK Primary

Addresses

Primary practice location

6465 S Yale Ave
Suite 811
Tulsa, OK 74136-7823

Mailing address

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3310
Phone (918) 488-6001

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
I20080929000394 OK Practitioner - Plastic and Reconstructive Surgery 5395812663 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23427OKMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Jul 1, 2008 Accepting new patients
Tulsa Oklahoma Plastic Surgery Plastic Surgery Current Accepting new patients

Locations

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6465 S Yale Ave
Ste 101
Tulsa, OK 74136
Phone (918) 492-0484

6465 S Yale Ave
Ste 811
Tulsa, OK 74136
Phone (918) 524-0080

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1801937370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "address_2": "SUITE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363310",
            "telephone_number": "918-488-6001",
            "fax_number": "918-488-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 811",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-502-7175",
            "fax_number": "918-502-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OK",
            "license": "23427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.