SOPUKRO W TIENABESO (M.D.) – Internal Medicine Physician, NPI 1770513442
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,474 INTERNAL MEDICINE in OK
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Provider Addresses for SOPUKRO W TIENABESO (M.D.)
1316 NW 170TH ST
EDMOND, OK 730037410
Phone: (405) 285-0796
Type: Mailing
1, Clark Bass Boulevard, McAlester, Pittsburg County, Oklahoma, 74501, United States
MCALESTER, OK 745014209
Phone: (918) 426-1800
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: 2018-12-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051020000851 | I | Internal Medicine | OK | TBD |
| I20181214002014 | I | Internal Medicine | TX | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 56 | 23 | $0 |
| 99238 | Hospital discharge day management, 30 minutes or less | 15 | 15 | $0 |
Insurance plans in this area (ZIP 73003)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OK | |
| - | OK | |
| Diagnostic Radiology | OK | |
| Nurse Practitioner | OK | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology, Interventional Radiology, Diagnostic Radiology | OK | |
| Interventional Radiology, Diagnostic Radiology, Diagnostic Radiology | OK | |
| - | VA |
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