NPIMap

Individual provider Active NPI

Melanie Nyeh Ketchandji, M.D

  • Urology Physician
  • Tulsa, OK
National Provider Identifier
1811247885
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
31609 Issued in OK
Practice address
1145 South Utica Avenue
Suite 202
Tulsa, OK 74104-4022
Phone
(918) 579-3130
Fax
(918) 579-3139
NPI assigned
Sep 17, 2012
Last updated
Aug 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 31609 OK Primary

Addresses

Primary practice location

1145 South Utica Avenue
Suite 202
Tulsa, OK 74104-4022

Mailing address

1145 S Utica Ave
Ste 202
Tulsa, OK 74104-4022
Phone (918) 579-3130

Other identifiers 1

IdentifierTypeStateIssuer
200596260AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914001411 OK Practitioner - Urology 1052628781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical Branch at Galveston, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1501 N Florence Ave
Suite 101 201 250 and 300
Claremore, OK 74017-3179
Phone (918) 579-3627

8803 S 101St E Ave
Suite 385
Tulsa, OK 74133-5779
Phone (918) 250-2033

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31609OKMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Urology CurrentSince Sep 1, 2015 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Sep 1, 2015 Accepting new patients
Ahs Claremore Regional Hospital, LLC. Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
Ahs Southcrest Hospital, LLC Past Accepting new patients

Locations

1501 N Florence Ave
Ste 101
Claremore, OK 74017
Phone (918) 341-4532

1501 N Florence Ave
Ste 201
Claremore, OK 74017
Phone (918) 341-1886

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

1145 S Utica Ave
Ste 202
Tulsa, OK 74104
Phone (918) 560-3838

8803 S 101st East Ave
Ste 385
Tulsa, OK 74133
Phone (918) 250-2033

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: mketchandji106863@ahs.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1811247885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044022",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SOUTH UTICA AVENUE",
            "address_2": "SUITE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044022",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHANDJI",
        "first_name": "MELANIE",
        "middle_name": "NYEH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "31609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200596260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.