NPIMap

Organization Active NPI

Elite Family Medicine LLC

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
National Provider Identifier
1992224349
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ELITE FAMILY MEDICINE LLC
Practice address
3336 E 32ND St Ste 205
Tulsa, OK 74135-4454
Phone
(918) 398-0800
Fax
(918) 398-0810
NPI assigned
Sep 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Dr. Vishal Aggarwal, MD
Title
Member
Phone
(918) 742-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3336 E 32ND St Ste 205
Tulsa, OK 74135-4454

Mailing address

3336 E 32ND St Ste 205
Tulsa, OK 74135-4454
Phone (918) 398-0800

Other practice location 1

120 S 3rd St
Ponca City, OK 74601-5308
Phone (918) 398-0800

Other identifiers 1

IdentifierTypeStateIssuer
200749030BMedicaidOK

National Provider Directory

National Provider Directory

Locations

120 S 3rd St
Ponca City, OK 74601
Phone (918) 398-0800

3336 E 32nd St
Ste 205
Tulsa, OK 74135
Phone (918) 398-0330

3336 E 32nd St
Tulsa, OK 74135
Phone (918) 727-8000

3336 E 32nd St
Ste 220
Tulsa, OK 74135
Phone (918) 255-7246

1015 E Parkway
Gatlinburg, TN 37738
Phone (865) 412-1225

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17465/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1992224349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 E 32ND ST STE 205",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354454",
            "telephone_number": "918-398-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 E 32ND ST STE 205",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354454",
            "telephone_number": "918-398-0800",
            "fax_number": "918-398-0810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Ponca City",
            "state": "OK",
            "postal_code": "746015308",
            "country_code": "US",
            "telephone_number": "918-398-0800",
            "fax_number": "918-398-0810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "AGGARWAL",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-742-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200749030B",
            "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 Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.