Amanda Michelle Groden, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

6665 Issued in OK

Practice address

10109 E 79TH St
Tulsa, OK 74133-4564

Phone

(918) 233-9550

NPI assigned

Feb 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agroden17509@muscogeecreeknation.direct-ci.com

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.

• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923

  Pediatrics

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Okmulgee, OK
  • NPI 1326446188
  NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Oklahoma State University

  • Medical Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1306882261

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1912407305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W K ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-233-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Eunice Burns Rd",
            "address_purpose": "LOCATION",
            "city": "Eufaula",
            "state": "OK",
            "postal_code": "744324052",
            "country_code": "US",
            "telephone_number": "918-689-2547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRODEN",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Matt Griswold, D.C.
• Jennifer Grizzle
• Maureen E Grizzle, LMFT
• David Clay Groat, RN
• Kelly Andrea Grober, PHARM.D.
• Jessica Groetken
• Ryan Groetken
• Valerie E Grogan, MS, RD, LD
• Stanley E. Grogg, DO
• Nicholas Ryan Groom, LPN

• Pediatrics Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.