NPIMap

Individual provider Active NPI

Tyson Richard Trimble, D.O.

  • Orthopaedic Surgery Physician
  • Grove, OK
National Provider Identifier
1851555239
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4694 Issued in OK
Practice address
900 E 13TH St
Suite 104
Grove, OK 74344-2975
Phone
(918) 786-3391
Fax
(918) 786-7264
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4694 OK Primary

Addresses

Primary practice location

900 E 13TH St
Suite 104
Grove, OK 74344-2975

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (918) 786-3391

Other identifiers 2

IdentifierTypeStateIssuer
200216420BMedicaidOK
200462050OMedicaidOK

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
I20120813000771 OK Practitioner - Orthopedic Surgery 2264688985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

900 E 13TH St
Grove, OK 74344-2976

Hospital & facility affiliations

  • Integris Home Care Northeast Home health agency, Miami, OK, CCN 377050
  • Amedisys Home Health Home health agency, Grove, OK, CCN 377072
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement12
Lower limb (leg) arthroscopy (minimally invasive joint repair)14
Upper limb (arm) arthroscopy (minimally invasive joint repair)22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Oct 1, 2013 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Integris Grove Hospital Past Accepting new patients
Integris Miami Hospital Past Accepting new patients

Locations

900 E 13th St
Ste 104
Grove, OK 74344
Phone (918) 786-3100

115 W 13th St
Grove, OK 74344
Phone (918) 786-2226

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: ttrimble12868@direct.integrisok.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1851555239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "918-786-3391",
            "fax_number": "918-786-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 13TH ST",
            "address_2": "SUITE 104",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442975",
            "telephone_number": "918-786-3391",
            "fax_number": "918-786-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "TYSON",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OK",
            "license": "4694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200216420B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200462050O",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

Verify at the official NPI Registry.