Individual provider Active NPI

Stanley Kyle Zimmerman, MD

  • Interventional Cardiology Physician
  • Tulsa, OK
National Provider Identifier
1861614737
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
28995 Issued in OK
Practice address
9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718
Phone
(918) 592-0999
Fax
(918) 878-2499
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 946353 KS
Interventional Cardiology Physician 207RI0011X 28995 OK Primary

Addresses

Primary practice location

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718

Mailing address

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718
Phone (918) 592-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120628000603 OK Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3173788973 Reassigns benefits to 2 organizations
I20230821001674 TX Practitioner - Cardiovascular Disease (Cardiology) 3173788973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Suite 100
Owasso, OK 74055-6638
Phone (918) 376-8400

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 592-0999

1265 S Utica Ave
Tulsa, OK 74104-4243

2401 W Main St
Henryetta, OK 74437-3893
Phone (918) 650-1100

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Hospital & facility affiliations

  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
  • Hillcrest Hospital Henryetta Hospital, Henryetta, OK, CCN 370183
  • Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
  • Hillcrest Hospital Cushing Hospital, Cushing, OK, CCN 370099

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting26
Varicose vein removal16
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
946353KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Jul 5, 2023 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2018 Accepting new patients
Creek Nation Hospital & Clinics Internal Medicine Current Accepting new patients
Ahs Oklahoma Heart LLC CurrentSince Jul 23, 2012 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2018 Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
Oklahoma Heart Inc Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Locations

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1038
Tulsa, OK 74182

Dept 1467
Tulsa, OK 74182

Dept 1218
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: szimmerman106921@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4

Organizations & group practices 8

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 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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1861614737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999",
            "fax_number": "918-878-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "STANLEY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "946353",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OK",
            "license": "28995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.