Organization Active NPI

Sycamore Branch Inc

  • Nephrology Physician
  • Oklahoma City, OK
National Provider Identifier
1902449671
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SYCAMORE BRANCH INC
Practice address
810 NW 10TH St Ste a
Oklahoma City, OK 73106-7216
Phone
(405) 272-8367
NPI assigned
Oct 24, 2019
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Dr. Joseph Ghata, MD
Title
Owner
Phone
(405) 413-3487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

810 NW 10TH St Ste a
Oklahoma City, OK 73106-7216

Mailing address

PO Box 892037
Oklahoma City, OK 73189-2037
Phone (405) 691-4703

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL OKLAHOMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191122000507 OK Part B Supplier - Clinic/Group Practice 1759713159 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1902449671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 892037",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731892037",
            "telephone_number": "405-691-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NW 10TH ST STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731067216",
            "telephone_number": "405-272-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE BRANCH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "GHATA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-413-3487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OKLAHOMA",
            "affiliation": "N",
            "address_1": "810 NW 10th St Ste A",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731067216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.