NPIMap

Individual provider Active NPI

Samuel M Kammerzell, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1902293103
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6431 Issued in OK
Practice address
8115 S Memorial Dr
Tulsa, OK 74133-4331
Phone
(918) 254-6315
Fax
(918) 403-6315
NPI assigned
Apr 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6431 OK Primary

Addresses

Primary practice location

8115 S Memorial Dr
Tulsa, OK 74133-4331

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 254-6315

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
I20181126001687 OK Practitioner - Family Practice 8022362359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

1919 S Wheeling Ave
Suite 200
Tulsa, OK 74104-5631
Phone (918) 748-7600

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2967

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6431OKMDSpeech/Language/Hearing Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc Family Medicine CurrentSince Sep 7, 2020 Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Dec 6, 2022 Accepting new patients
St. John Physicians, Inc CurrentSince Sep 18, 2018 Accepting new patients
St John Urgent Care Clinics Inc Past Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

7501 Riverside Pkwy
Tulsa, OK 74136
Phone (918) 710-4200

4720 S Harvard Ave
Ste 100
Tulsa, OK 74135
Phone (918) 749-6730

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1919 S Wheeling Ave
Ste 200
Tulsa, OK 74104
Phone (918) 748-7600

Interoperability endpoints

  • Direct secure messaging: samuel.kammerzell.1@20767.direct.athenahealth.com

Organizations & group practices 5

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 12

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": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1902293103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-254-6315",
            "fax_number": "918-403-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334331",
            "telephone_number": "918-254-6315",
            "fax_number": "918-403-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMERZELL",
        "first_name": "SAMUEL",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-25",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.