Active NPI
Oklahoma State University
- Medical Specialty Clinic/Center
- Tulsa, OK
National Provider Identifier
1831250802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- Legal business name
- OKLAHOMA STATE UNIVERSITY
- Practice address
- 1705 E 19TH St Ste 600
Tulsa, OK 74104-5417 - Phone
- (918) 382-3190
- Fax
- (918) 382-6789
- NPI assigned
- Dec 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eric John Polak
- Title
- VP
- Phone
- (918) 561-8422
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | Primary |
Addresses
Primary practice location
1705 E 19TH St Ste 600
Tulsa, OK 74104-5417
Mailing address
5310 E 31St St FL 13
Tulsa, OK 74135-5018
Phone (918) 567-5701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100757080A | Medicaid | OK |
Other names 1
- OSU Physicians Pediatrics
National Provider Directory
National Provider Directory- Tax ID family
- Sallisaw State Veterans Home
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- General Practice Dentistry
- Oklahoma City, OK
- NPI 1770731275
-
- Medical Specialty Clinic/Center
- Norman, OK
- NPI 1770674756
-
- Community/Behavioral Health Agency
- Norman, OK
- NPI 1881716900
-
- Community/Behavioral Health Agency
- Lawton, OK
- NPI 1932569001
-
- Psychiatric Hospital
- Lawton, OK
- NPI 1912275306
-
- Community/Behavioral Health Agency
- Norman, OK
- NPI 1801087770
-
- Long Term Care Pharmacy
- Enid, OK
- NPI 1790889038
-
- Community/Behavioral Health Agency
- Oklahoma City, OK
- NPI 1881997799
-
- Supports Brokerage Agency
- Stillwater, OK
- NPI 1801090790
-
- Emergency Care Clinic/Center
- Oklahoma City, OK
- NPI 1891061636
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tulsa, OK
- NPI 1801150131
-
- Case Management Agency
- Oklahoma City, OK
- NPI 1790802882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771372800000",
"number": "1831250802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5310 E 31ST ST FL 13",
"city": "TULSA",
"state": "OK",
"postal_code": "741355018",
"telephone_number": "918-567-5701",
"fax_number": "918-561-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 E 19TH ST STE 600",
"city": "TULSA",
"state": "OK",
"postal_code": "741045417",
"telephone_number": "918-382-3190",
"fax_number": "918-382-6789"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OKLAHOMA STATE UNIVERSITY",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-13",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A",
"authorized_official_last_name": "POLAK",
"authorized_official_first_name": "ERIC",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "918-561-8422"
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100757080A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "OSU Physicians Pediatrics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tulsa, OK
- Oklahoma State University
- Oklahoma State University
- Oklahoma State University
- Oklahoma State University
- Oklahoma State University
- Oklahoma State University Medical Center
- Oklahoma State University Medical Center
- Oklahoma State University Medical Center
- Oklahoma State University Medical Center Trust
- Oklahoma State University Medical Center Trust
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.