NPIMap

Individual provider Active NPI

Preethi Sivarama Krishnan, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1861611675
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26009 Issued in OK
Practice address
3330 NW 56TH St
Suite 220
Oklahoma City, OK 73112-4479
Phone
(405) 713-7422
Fax
(405) 713-7436
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26009 OK Primary

Addresses

Primary practice location

3330 NW 56TH St
Suite 220
Oklahoma City, OK 73112-4479

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 713-7422

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
I20081023000238 OK Practitioner - Family Practice 8820156623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3330 NW 56TH
220 Integris Family Care Baptist
Oklahoma City, OK 73112-4418
Phone (405) 713-7422

Hospital & facility affiliations

  • Integris Home Care Oklahoma City Home health agency, Oklahoma City, OK, CCN 377051
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211
  • Lakeside Women'S Hospital, a Member of Integris He Hospital, Oklahoma City, OK, CCN 370199

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26009OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
Summit Medical Center Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients

Locations

3330 NW 56th St
Ste 220
Oklahoma City, OK 73112
Phone (405) 713-7422

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

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

Interoperability endpoints

  • Direct secure messaging: pkrishnan11110@direct.integrisok.com

Organizations & group practices 3

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 11

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1861611675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-7422",
            "fax_number": "405-713-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST",
            "address_2": "SUITE 220",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124479",
            "telephone_number": "405-713-7422",
            "fax_number": "405-713-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "PREETHI",
        "middle_name": "SIVARAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.