NPIMap

Individual provider Active NPI

Mark Street, MD

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1982165361
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34812 Issued in OK
Practice address
1245 S Utica Ave Ste 301
Tulsa, OK 74104-4214
Phone
(918) 382-2536
Fax
(918) 382-2576
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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 34812 OK
Internal Medicine Physician 207R00000X 34812 OK Primary

Addresses

Primary practice location

1245 S Utica Ave Ste 301
Tulsa, OK 74104-4214

Mailing address

1245 S Utica Ave Ste 301
Tulsa, OK 74104-4214
Phone (918) 382-2536

Other practice location 1

4502 E 41st St
Tulsa, OK 74135-2536
Phone (918) 619-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707001183 OK Practitioner - Internal Medicine 2163802265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Owasso, OK 74055-6638

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

1245 S Utica Ave
Tulsa, OK 74104-4214

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

4408 S Harvard Ave
Tulsa, OK 74135-2615
Phone (918) 574-0350

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34812OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Ahs Oklahoma Physician Group LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

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

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

Dept 1206
Tulsa, OK 74182

1245 S Utica Ave
Ste 301
Tulsa, OK 74104
Phone (918) 382-2536

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: mstreet113351@ahs.direct-ci.com

Organizations & group practices 2

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 10

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1982165361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S UTICA AVE STE 301",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044214",
            "telephone_number": "918-382-2536",
            "fax_number": "918-382-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S UTICA AVE STE 301",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044214",
            "telephone_number": "918-382-2536",
            "fax_number": "918-382-2576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 E 41st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741352536",
            "country_code": "US",
            "telephone_number": "918-619-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREET",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "34812",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "34812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.