Eugene J Ichinose, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

26012 Issued in OK

Practice address

1265 South Utica Ave
Suite 300
Tulsa, OK 74104-4243

Phone

(918) 592-0999

Fax

(918) 592-1021

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Louisiana State University School of Medicine in New Orleans, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Hillcrest Hospital Pryor Hospital, Pryor, OK, CCN 370015
• Integris Grove Hospital Hospital, Grove, OK, CCN 370113
• Integris Miami Hospital Hospital, Miami, OK, CCN 370004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eichinose106913@ahs.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.

• Ahs Oklahoma Heart LLC

  • Specialist
  • Tulsa, OK
  • NPI 1780857540
  Medicare reassignment Care Compare group NPD
• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  NPD (past)
• Integris Cardiovascular Physicians LLC

  • Cardiovascular Disease Physician
  • Oklahoma City, OK
  • NPI 1306129598
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Pryor Hospital, LLC

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Integris Grove Hospital

  • General Acute Care Hospital
  • Grove, OK
  • NPI 1467473579
  Care Compare affiliation
• Integris Grove Hospital

  • Ambulance
  • Grove, OK
  • NPI 1770626608

  Hospital

  Care Compare affiliation
• Integris Miami Hospital

  • General Acute Care Hospital
  • Miami, OK
  • NPI 1114931342
  Care Compare affiliation
• Integris Miami Hospital

  • Ambulance
  • Miami, OK
  • NPI 1861534786

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1952378978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 SOUTH UTICA AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHINOSE",
        "first_name": "EUGENE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "209618",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "209618",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "209618",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MA",
            "license": "209618",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "26012",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OK",
            "license": "26012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200198060A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00642514",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Idoc Oklahoma Telehealth Solutions LLC
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• Interventional Cardiology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Interventional Cardiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.