NPIMap

Individual provider Active NPI

Michael S Charles, MD

  • Surgical Critical Care Physician
  • Tulsa, OK
National Provider Identifier
1942293097
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
28445 Issued in OK
Practice address
1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5635
Phone
(918) 748-7676
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X H5534 TX
Surgical Critical Care Physician 2086S0102X 28445 OK Primary

Addresses

Primary practice location

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5635

Mailing address

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5635
Phone (918) 748-7676

Other identifiers 1

IdentifierTypeStateIssuer
123647301MedicaidTX

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
I20111215000673 OK Practitioner - General Surgery 8224117213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1919 S Wheeling Ave
Tulsa, OK 74104-5635

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28445OKMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. CurrentSince Jul 30, 2011 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 30, 2011 Accepting new patients
Regional Clinics of Longview 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

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104
Phone (918) 748-7676

1919 S Wheeling Ave
Ste 600
Tulsa, OK 74104
Phone (918) 634-7500

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

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

Interoperability endpoints

  • Direct secure messaging: michael.charles@direct.stjohnhealthsystem.com

Organizations & group practices 4

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 6

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1942293097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045635",
            "telephone_number": "918-748-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045635",
            "telephone_number": "918-748-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "H5534",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OK",
            "license": "28445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123647301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.