Individual provider Active NPI

Miranda Celeste Gaskamp, D.O.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tulsa, OK
National Provider Identifier
1962793018
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
5213 Issued in OK
Practice address
744 W 9TH St
Tulsa, OK 74127-9020
Phone
(918) 587-2561
NPI assigned
Apr 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 5213 OK Primary

Addresses

Primary practice location

744 W 9TH St
Tulsa, OK 74127-9020

Mailing address

1717 S Utica Ave
Ste a
Tulsa, OK 74104-5346
Phone (918) 519-8364

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
I20130103000316 OK Practitioner - Emergency Medicine 1355594177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5213OKMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. CurrentSince Jul 31, 2017 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC CurrentSince Oct 1, 2024 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 31, 2017 Accepting new patients
Hospital Care Consultants Region II Inc CurrentSince Oct 20, 2012 Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients
St John Sapulpa, Inc. Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

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

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

744 W 9th St
Tulsa, OK 74127
Phone (918) 587-2561

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1962793018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "918-519-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-587-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKAMP",
        "first_name": "MIRANDA",
        "middle_name": "CELESTE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "5213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.