Individual provider Active NPI

Michael John Walters, M.D.

  • Vascular & Interventional Radiology Physician
  • Tulsa, OK
National Provider Identifier
1962768341
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
34629 Issued in OK
Practice address
4500 S Garnett Rd Ste 300
Tulsa, OK 74146-5238
Phone
(918) 935-3550
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 34629 OK
Vascular & Interventional Radiology Physician 2085R0204X 34629 OK Primary
Vascular & Interventional Radiology Physician 2085R0204X MD-21972 HI

Addresses

Primary practice location

4500 S Garnett Rd Ste 300
Tulsa, OK 74146-5238

Mailing address

4500 S Garnett Rd Ste 300
Tulsa, OK 74146-5238
Phone (918) 728-6194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK, HI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190621000329 TX Practitioner - Diagnostic Radiology 6901198951 Reassigns benefits to 10 organizations
I20190709002215 OK Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 6901198951 Reassigns benefits to 1 organization
I20210804001930 HI Practitioner - Diagnostic Radiology 6901198951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilo Benioff Medical CenterGroup PAC ID 1254422900, 131 clinicians
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (808) 932-3000

Hospital & facility affiliations

  • Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-21972HIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Feb 8, 2020 Accepting new patients
Hilo Benioff Medical Center CurrentSince Jul 12, 2021 Accepting new patients
Wewoka Indian Health CurrentSince Feb 12, 2020 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Dec 22, 2019 Accepting new patients
El Reno Indian Health Center CurrentSince Oct 15, 2019 Accepting new patients
Cherokee Nation Current Accepting new patients
Anadarko Indian Health Center CurrentSince Aug 21, 2019 Accepting new patients
Hilo Benioff Medical Center CurrentSince Jul 12, 2021 Accepting new patients
Watonga Indian Health Center CurrentSince Oct 15, 2019 Accepting new patients
Kau Hospital CurrentSince Jul 12, 2021 Accepting new patients
Oklahoma Diagnostic Imaging LTD CurrentSince Oct 8, 2019 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2019 Accepting new patients
Lawton Indian Hospital CurrentSince Aug 21, 2019 Accepting new patients
Pawnee Indian Health Center CurrentSince Nov 3, 2019 Accepting new patients
Kau Hospital CurrentSince Jul 12, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Sep 23, 2019 Accepting new patients
Clinton Indian Health Center CurrentSince Oct 15, 2019 Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2019 Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2019 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 8, 2020 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Cherokee Nation Current Accepting new patients
Pawnee IHS Pharmacy PastSince Sep 21, 2025 Accepting new patients

Locations (25 of 30)

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

201 E Parker McKenzie Dr
Anadarko, OK 73005
Phone (405) 247-7900

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

1201 Heritage Cir
Pawnee, OK 74058
Phone (918) 762-2517

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: mwalters21723@hhsc.direct-ci.com

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 1

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1962768341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465238",
            "telephone_number": "918-728-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465238",
            "telephone_number": "918-935-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "34629",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OK",
            "license": "34629",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "HI",
            "license": "MD-21972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.