Clark Jiro Tingleaf, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

23509 Issued in OK

Practice address

10512 N 110TH East Ave
Ste 200
Owasso, OK 74055-6636

Phone

(918) 376-8926

Fax

(918) 377-8936

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

University of Texas Medical School at San Antonio, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
• Hillcrest Hospital Pryor Hospital, Pryor, OK, CCN 370015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctingleaf118707@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Urology

  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• Northeastern Oklahoma Urology, P.C.

  • Specialist
  • Claremore, OK
  • NPI 1619057551
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Claremore Regional Hospital, LLC.

  dba Hillcrest Hospital Claremore

  • General Acute Care Hospital
  • Claremore, OK
  • NPI 1023398807
  Care Compare affiliation
• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Bailey Medical Center, LLC

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1205846037
  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1881624153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 N 110TH EAST AVE",
            "address_2": "STE 200",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556636",
            "telephone_number": "918-376-8926",
            "fax_number": "918-377-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 N 110TH EAST AVE",
            "address_2": "STE 200",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556636",
            "telephone_number": "918-376-8926",
            "fax_number": "918-377-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGLEAF",
        "first_name": "CLARK",
        "middle_name": "JIRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "23509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015250B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Ryan Thornton
• Shelly Thorpe
• Angela Nicole Thorson
• Cassidy Tibbles
• Jessica Tilley, RD, LD
• Jason Torcivia
• Touchstone Imaging of Oklahoma, LLC
• Vic Hill Trammell Jr., D.D.S.
• Kellie Tran, PHARMD
• Yvonne Diem Trang Tran, PHARMD

• Urology Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Urology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.