Individual provider Active NPI

Cynthia Wise, APRN

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1871078535
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
101985 Issued in OK
Practice address
12697 E 51St St
Tulsa, OK 74146-6236
Phone
(918) 505-3200
Fax
(918) 505-3225
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 101985 OK Primary

Addresses

Primary practice location

12697 E 51St St
Tulsa, OK 74146-6236

Mailing address

12697 E 51St St
Tulsa, OK 74146-6236
Phone (918) 505-3200

Other practice location 1

10506 S Memorial Dr
Tulsa, OK 74133-6914
Phone (918) 943-1050

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181231000184 OK Practitioner - Nurse Practitioner 0547443335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12697 E 51St St
Tulsa, OK 74146-6236
Phone (918) 505-3200

Merit-based Incentive Payment System (MIPS)

Final score
91 of 100Reported as group
Quality
86.79
Promoting interoperability
100
Improvement activities
40
Cost
76.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101985OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer Specialists and Research Institute LLC CurrentSince Oct 25, 2018 Accepting new patients
Tulsa Cancer Institute PLLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Oct 25, 2018 Accepting new patients

Locations

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1871078535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-505-3200",
            "fax_number": "918-505-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-505-3200",
            "fax_number": "918-505-3225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10506 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741336914",
            "country_code": "US",
            "telephone_number": "918-943-1050",
            "fax_number": "918-369-3209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "CYNTHIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "101985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.