Individual provider Active NPI

Joseph M Fugaro, MD

  • Surgical Critical Care Physician
  • Tulsa, OK
National Provider Identifier
1972536969
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
37979 Issued in OK
Practice address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone
(918) 382-2560
Fax
(918) 382-2569
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 2006018901 MO
Surgical Critical Care Physician 2086S0102X 37979 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Tulsa, OK 74104-4012

Mailing address

1145 S Utica Ave Ste 110
Tulsa, OK 74104-4013
Phone (918) 579-3825

Other practice location 1

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-5976

Other practice location 2

2101 Corona Rd Ste 102
Columbia, MO 65203-2582
Phone (573) 234-1800

Other practice location 3

3255 Independence St
Landmark Hospital
Cape Girardeau, MO 63701-4914
Phone (573) 335-1091

Other identifiers 1

IdentifierTypeStateIssuer
201257300MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MT, OK3 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
I20061017000120 MO Practitioner - Critical Care (Intensivists)Practitioner - HospitalistPractitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular SurgeryPractitioner - General Surgery 4486650330 Reassigns benefits to 3 organizations
I20201014001482 MT Practitioner - General Surgery 4486650330 Reassigns benefits to 1 organization
I20210713001436 OK Practitioner - Critical Care (Intensivists) 4486650330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-9393

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37979OKMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Sep 1, 2020 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Aug 1, 2021 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients
The Curators of the University of Missouri Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1003 E Cherry St
Troy, MO 63379
Phone (636) 528-6755

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

3528 Gabel Rd
Billings, MT 59102
Phone (406) 373-8000

3572 Hesper Rd
Billings, MT 59102
Phone (406) 413-6200

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

Dept 1206
Tulsa, OK 74182

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Interoperability endpoints

  • Direct secure messaging: jfugaro332774@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 11

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 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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1972536969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3825",
            "fax_number": "918-579-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-382-2560",
            "fax_number": "918-382-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Saint Francis Dr",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637035049",
            "country_code": "US",
            "telephone_number": "573-331-5976",
            "fax_number": "573-331-5040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Corona Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652032582",
            "country_code": "US",
            "telephone_number": "573-234-1800",
            "fax_number": "573-234-1799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3255 Independence St",
            "address_2": "Landmark Hospital",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637014914",
            "country_code": "US",
            "telephone_number": "573-335-1091",
            "fax_number": "573-331-8453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGARO",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2006018901",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OK",
            "license": "37979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201257300",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.