Unknown Individual – Internal Medicine Physician, NPI 1053504084
Internal Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Ascension Saint John Medical Center, 1923, South Utica Avenue, Swan Lake, Tulsa, Tulsa County, Oklahoma, 74104, United States
STE E
TULSA, OK 741046520
Phone: (918) 832-6049
Fax: (918) 832-6055
Type: Mailing
Holliman Medical Building, 1705, East 19th Street, Yorktown, Tulsa, Tulsa County, Oklahoma, 74104, United States
STE 302
TULSA, OK 741045405
Phone: (918) 748-7585
Fax: (918) 748-7539
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 140 | 136 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 100 | 95 | $0 |
| 99291 | Critical care, first 30-74 minutes | 20 | 20 | $0 |
Insurance plans in this area (ZIP 74104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| - | OK | |
| - | OK | |
| Family Practice | OK | |
| - | OK | |
| - | OK | |
| - | OK | |
| Emergency Medicine | OK | |
| - | OK | |
| - | OK |
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