Individual provider Active NPI

Kala Marie Gaydos, APRN-CNP

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1972876191
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
96559 Issued in OK
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

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200772750AMedicaidOK

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190401002261 OK Practitioner - Nurse Practitioner 7315288370 Reassigns benefits to 1 organization

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
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

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 Hospital, Owasso, OK, CCN 370228
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
820817TXMDFamily Nurse Practitioner
96559OKMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince Mar 1, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC Nurse Practitioner CurrentSince Mar 1, 2019 Accepting new patients
Elite Family Medicine LLC Past Accepting new patients
The Spine and Pain Center LLC PastSince Dec 1, 2018 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

  • Direct secure messaging: kgaydos201329@ahs.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/17465/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kala.gaydos.1@17465.direct.athenahealth.com
  • FHIR API: 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.