NPIMap

Individual provider Active NPI

Cordell Lee Privat, MD

  • Vascular & Interventional Radiology Physician
  • Tulsa, OK
National Provider Identifier
1982867511
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
30549 Issued in OK
Practice address
5801 E 41St St Ste 900
Tulsa, OK 74135-5631
Phone
(918) 747-4975
Fax
(918) 743-8552
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 30549 OK Primary

Addresses

Primary practice location

5801 E 41St St Ste 900
Tulsa, OK 74135-5631

Mailing address

PO Box 4930
Tulsa, OK 74159-0930
Phone (918) 747-4975

Other identifiers 1

IdentifierTypeStateIssuer
200537380AMedicaidOK

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
I20140916002200 OK Practitioner - Interventional Radiology 9830318377 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Radiology PLLCGroup PAC ID 8628332061, 217 clinicians

Practice addresses (Care Compare)

5124 E 106TH St
Tulsa, OK 74137-7217
Phone (888) 264-0330

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
  • Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312

Merit-based Incentive Payment System (MIPS)

Final score
91 of 100Reported as group
Quality
86.79
Promoting interoperability
100
Improvement activities
40
Cost
76.43

Merit-based Incentive Payment System (MIPS)

Final score
77.7 of 100Reported as group
Quality
91.25
Improvement activities
40
Cost
41.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30549OKMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer Specialists and Research Institute LLC CurrentSince Feb 10, 2016 Accepting new patients
Concord Radiology PLLC CurrentSince Jan 1, 2025 Accepting new patients
Coaxion PLLC CurrentSince Oct 13, 2025 Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Feb 10, 2016 Accepting new patients
Tulsa Radiology Associates Inc CurrentSince Jul 1, 2014 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
Radiology Consultants of Tulsa Inc Past Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Past Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

3500 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-1555

901 N Strong Blvd
McAlester, OK 74501
Phone (918) 426-0625

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

4111 S Darlington Ave
Ste 700
Tulsa, OK 74135
Phone (918) 743-8943

5801 E 41st St
Ste 900
Tulsa, OK 74135
Phone (918) 743-8838

Interoperability endpoints

  • Direct secure messaging: cordell.privat@direct.stjohnhealthsystem.com

Organizations & group practices 9

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 7

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1982867511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4930",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741590930",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 E 41ST ST STE 900",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355631",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVAT",
        "first_name": "CORDELL",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OK",
            "license": "30549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200537380A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.