Blake Justin Lesselroth, MD, MBI

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34337 Issued in OK

Practice address

4502 E 41St St
Tulsa, OK 74135-2536

Phone

(918) 660-3596

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Tulane University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Board of Regents of the University of Oklahoma Ou Physicians TulsaGroup PAC ID 5395645329, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blesselroth28310@ouhealth.direct-ci.net

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.

• Board of Regents of the University of Oklahoma Ou Physicians Tulsa

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1154385730
  Medicare reassignment Care Compare group NPD
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1801997390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E 39TH ST APT 2-349",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741053343",
            "telephone_number": "971-303-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-660-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSELROTH",
        "first_name": "BLAKE",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD, MBI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD24554",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "34337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Michelle Lepper, MS, LPC, NCC
• Anthony Paul Lepre, DMD
• Katherine Marie Lesicka
• Lesley V Landis MD PLLC (Landis Plastic Surgery)
• Lora Mae Leslie Demoss, LCSW
• Jenny Elizabeth Lessley, DO
• Justin S. Lessley, P.T.
• Frank R Lester, DPH
• Lamarco Terron Lester
• Mitchell N Lester, MD

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.