Organization Active NPI

Vista Wound Specialists LLC

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1891583175
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISTA WOUND SPECIALISTS LLC
Practice address
9340 S Florence Ave
Tulsa, OK 74137-3649
Phone
(918) 671-9779
NPI assigned
Apr 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Eric Engstrom, MDNPI 1225484611
Title
Co-Owner
Phone
(918) 671-9779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9340 S Florence Ave
Tulsa, OK 74137-3649

Mailing address

9340 S Florence Ave
Tulsa, OK 74137-3649
Phone (918) 671-9779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250709001349 OK Part B Supplier - Clinic/Group Practice 5991219289 Receives reassigned benefits from 3 practitioners
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

9318 S Toledo Ct
Tulsa, OK 74137
Phone (918) 294-3668

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1891583175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 S FLORENCE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373649",
            "telephone_number": "918-671-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 S FLORENCE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741373649",
            "telephone_number": "918-671-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA WOUND SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "ENGSTROM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "918-671-9779",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.