Individual provider Active NPI

Ethel Vasquez-Harmon, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1922077536
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3264 Issued in OK
Practice address
1919 S Wheeling Ave
200
Tulsa, OK 74104-5638
Phone
(918) 748-7600
Fax
(918) 293-3109
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3264 OK Primary

Addresses

Primary practice location

1919 S Wheeling Ave
200
Tulsa, OK 74104-5638

Mailing address

1515 N. Harvard
Ste. E
Tulsa, OK 74115
Phone (918) 832-6049

Other identifiers 1

IdentifierTypeStateIssuer
100256910AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000925 OK Practitioner - Internal Medicine 6204966674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1994
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)

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

800 W Boise Cir
Suite 160
Broken Arrow, OK 74012-4932
Phone (918) 994-9160

8115 S Memorial Dr
Tulsa, OK 74133-4331
Phone (918) 254-6315

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3264OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc Internal Medicine CurrentSince Jul 15, 1998 Accepting new patients

Locations

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

8115 S Memorial Dr
Tulsa, OK 74133
Phone (918) 254-6315

1515 N Harvard Ave
Ste E
Tulsa, OK 74115
Phone (918) 832-6049

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

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

Interoperability endpoints

  • Direct secure messaging: eharmon@ubergroup.gwaydirect.com

Organizations & group practices 2

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 7

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1922077536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N. HARVARD",
            "address_2": "STE. E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74115",
            "telephone_number": "918-832-6049",
            "fax_number": "918-832-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7600",
            "fax_number": "918-293-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ-HARMON",
        "first_name": "ETHEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.