Active NPI
Diane Pentecost, M.D.
- Anesthesiology Physician
- Tulsa, OK
National Provider Identifier
1902868029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 16158
- Practice address
- 1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909 - Phone
- (918) 744-3664
- Fax
- (918) 748-7688
- NPI assigned
- Apr 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 16158 | OK | Primary |
Addresses
Primary practice location
1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Mailing address
1611 S Utica Ave
Ste 217
Tulsa, OK 74104-4909
Phone (918) 744-3664
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00335038 | Other | OK | RR MEDICARE |
| 100118480A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Anesthesia Specialists Partnership Medical Group | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- West Hollywood, CA
- NPI 1407805310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1902868029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 S UTICA AVE",
"address_2": "STE 217",
"city": "TULSA",
"state": "OK",
"postal_code": "741044909",
"telephone_number": "918-744-3664",
"fax_number": "918-748-7688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 S UTICA AVE",
"address_2": "STE 217",
"city": "TULSA",
"state": "OK",
"postal_code": "741044909",
"telephone_number": "918-744-3664",
"fax_number": "918-748-7688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTECOST",
"first_name": "DIANE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-04",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "16158",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00335038",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100118480A",
"state": "OK"
}
],
"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 May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.