PETER ALLAN IPPOLITI – Physician Assistant, NPI 1619750015

PETER ALLAN IPPOLITI is a healthcare provider. based in Tulsa, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5760 (OK). The NPI Number for PETER ALLAN IPPOLITI is 1619750015

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
PETER ALLAN IPPOLITI
NPI
1619750015
Phone
(405) 880-8046
Address
4904 S KNOXVILLE PL
Enumeration Date
17 August 2023
Last Update Date
30 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9189348347
Graduation Year
2025 (1 year ago)
PAC ID
7315427176
Group Practice PAC ID
6103302724
Professional Enrollment ID
I20260219001494
Address ID
OK741355631TU5801XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for PETER ALLAN IPPOLITI

  • 4904 S KNOXVILLE PL

    TULSA, OK 741353112

    Phone: (405) 880-8046

    Type: Mailing

  • 5801 E 41ST ST STE 900

    TULSA, OK 741355631

    Phone: (918) 934-8347

    Fax: (918) 743-8552

    Type: Mailing

  • 1120 S UTICA AVE

    TULSA, OK 741044012

    Phone: (405) 880-8046

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260219001494IPhysician AssistantOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74135)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103302724View full group profile
NameSpecialtyState
Diagnostic RadiologyOK
Interventional Radiology, Nuclear Medicine, Diagnostic RadiologyOH
Diagnostic RadiologyOK

Reviews

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Frequently asked questions

Can I cross-check PETER ALLAN IPPOLITI using NPI 1619750015?
NPI 1619750015 belongs to PETER ALLAN IPPOLITI; compare other details if you need extra assurance.
Would PETER ALLAN IPPOLITI appear as active to a payer?
You can treat PETER ALLAN IPPOLITI as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with PETER ALLAN IPPOLITI?
PETER ALLAN IPPOLITI's record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Oklahoma is PETER ALLAN IPPOLITI registered?
Use Tulsa, Oklahoma as the headline location for PETER ALLAN IPPOLITI here.
When was this NPI issued?
Enumeration for PETER ALLAN IPPOLITI is noted as August 17, 2023 where the registry provides it.

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