Individual provider Active NPI

Nghia Phan, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1831117233
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4251 Issued in OK
Practice address
4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone
(918) 728-6145
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4251 OK Primary

Addresses

Primary practice location

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229

Mailing address

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone (918) 728-6145

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
I20061121000249 OK Practitioner - Emergency Medicine 7012910763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians

Practice addresses (Care Compare)

12220 N Macarthur Blvd D
Mercy Gohealth Urgent Care NW Okc
Oklahoma City, OK 73162-1851
Phone (405) 437-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4251OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Nov 15, 2020 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

12220 N MacArthur Blvd
Ste D
Oklahoma City, OK 73162
Phone (405) 437-1100

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831117233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "NGHIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.