NPIMap

Individual provider Active NPI

Jennifer Elizabeth Peterson, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Tulsa, OK
National Provider Identifier
1902249592
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
34618 Issued in OK
Practice address
4802 S 109TH East Ave
Tulsa, OK 74146-5822
Phone
(918) 392-1400
Fax
(918) 392-1488
NPI assigned
Apr 12, 2013
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 35.133869 OH
Student in an Organized Health Care Education/Training Program 390200000X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 34618 OK Primary

Addresses

Primary practice location

4802 S 109TH East Ave
Tulsa, OK 74146-5822

Mailing address

4802 S 109TH East Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

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
I20190515001816 OK Practitioner - Orthopedic Surgery 3476854092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Virginia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4802 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement52
Knee replacement103
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Bone & Joint Associates PC Adult Reconstructive Orthopaedic Surgery CurrentSince Jul 1, 2019 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Osu Health System Anesthesia Past Accepting new patients

Locations

4802 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1601
  • Direct secure messaging: jpeterson@tbja.gwaydirect.com
  • Direct secure messaging: jpeterson261807@ahs.direct-ci.com
  • Direct secure messaging: jpeterson272655@direct.saintfrancis.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1902249592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1513",
            "fax_number": "918-392-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S 109TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465822",
            "telephone_number": "918-392-1400",
            "fax_number": "918-392-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OH",
            "license": "35.133869",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OK",
            "license": "34618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.