Active NPI
Kala Marie Gaydos, APRN-CNP
- Nurse Practitioner
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 96559
- Practice address
- 3336 E 32ND St Ste 220
Tulsa, OK 74135 - Phone
- (918) 398-0800
- Fax
- (918) 398-0800
- NPI assigned
- Feb 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 96559 | OK | |
| Family Nurse Practitioner | 363LF0000X | 820817 | TX | |
| Nurse Practitioner | 363L00000X | 96559 | OK | Primary |
Addresses
Primary practice location
3336 E 32ND St Ste 220
Tulsa, OK 74135
Mailing address
10512 N 110TH East Ave Ste 220
Owasso, OK 74055-6638
Phone (918) 376-8830
Other practice location 1
10512 N 110th East Ave Ste 220
Owasso, OK 74055-6638
Phone (918) 376-8830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200772750A | Medicaid | OK |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10512 N 110TH E Ave
Suite 240
Owasso, OK 74055-6638
Phone (918) 376-8450
Hospital & facility affiliations
- Bailey Medical Center, LLC
- Hillcrest Medical Center
- Hillcrest Hospital South
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 820817 | TX | MD | Family Nurse Practitioner |
| 96559 | OK | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Oklahoma Physician Group, LLC | Current | Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Nurse Practitioner | Current | Accepting new patients |
| Elite Family Medicine LLC | Past | Accepting new patients | |
| The Spine and Pain Center LLC | Past | Accepting new patients |
Locations
10512 N 110th East Ave
Ste 220
Owasso, OK 74055
Phone (918) 516-1919
10512 N 110th East Ave
Ste 240
Owasso, OK 74055
Phone (918) 376-8450
20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675
Dept 1206
Tulsa, OK 74182
9001 S 101st East Ave
Ste 270
Tulsa, OK 74133
Phone (918) 392-5470
Interoperability endpoints
- kgaydos201329@ahs.direct-ci.com
- https://api.platform.athenahealth.com/17465/brand/1/csg/1/fhir/r4
- kala.gaydos.1@17465.direct.athenahealth.com
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
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.
-
- Family Medicine Physician
- Tulsa, OK
- NPI 1235182775
Nurse Practitioner
-
- Rural Health Clinic/Center
- Cushing, OK
- NPI 1922683051
-
- Multi-Specialty Clinic/Center
- Tulsa, OK
- NPI 1992224349
-
- Pain Medicine (Anesthesiology) Physician
- Tulsa, OK
- NPI 1689144602
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1629057229
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1750661534
-
- General Acute Care Hospital
- Owasso, OK
- NPI 1205846037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1972876191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10512 N 110TH EAST AVE STE 220",
"city": "OWASSO",
"state": "OK",
"postal_code": "740556638",
"telephone_number": "918-376-8830",
"fax_number": "918-376-8839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3336 E 32ND ST STE 220",
"city": "TULSA",
"state": "OK",
"postal_code": "74135",
"telephone_number": "918-398-0800",
"fax_number": "918-398-0800"
}
],
"practiceLocations": [
{
"address_1": "10512 N 110th East Ave Ste 220",
"address_purpose": "LOCATION",
"city": "Owasso",
"state": "OK",
"postal_code": "740556638",
"country_code": "US",
"telephone_number": "918-376-8830",
"fax_number": "918-376-8839",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAYDOS",
"first_name": "KALA",
"middle_name": "MARIE",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-18",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OK",
"license": "96559",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "820817",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "96559",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200772750A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.