JOHN G IVANOFF (NPI# 1497725857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497725857 |
| Entity Type | Individual |
| Full Name | JOHN G IVANOFF |
| Credential | M.D. |
| Practice Address |
10505 E 91st St Suite 208 Tulsa OK 74133-5801 |
| Mailing Address |
6600 S Yale Ave Suite 1400 Tulsa OK 74136-3347 |
| Practice Telephone | 9184948500 |
| Mailing Telephone | 9184886001 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
19125 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | MEDICARE GROUP PIN | 300522262 | 01 |
| OK | 100023590A | 05 |
| Street Address |
10505 E 91ST ST SUITE 208 |
| City | TULSA |
| State | OK |
| Zip Code | 74133-5801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013913359 | Andrew Gottehrer | Internal Medicine | 10505 E 91st St, Suite 208, Tulsa, OK 74133-5801 | 2005-06-22 |
| 1538777552 | Kallie Danielle Garrett | Clinical Nurse Specialist | 10505 E 91st St, Tulsa, OK 74133-5801 | 2020-07-15 |
| 1871813543 | Loan Ngoc Nguyen | Obstetrics & Gynecology | 10505 E 91st St, Suite 203, Tulsa, OK 74133-5801 | 2010-06-04 |
| 1104152016 | Gastroenterology Associates Pllc | Internal Medicine | 10505 E 91st St, Suite 200, Tulsa, OK 74133-5803 | 2009-10-28 |
| 1083858138 | Andrew Lott Barker | Pain Medicine | 10505 E 91st St, Suite 205, Tulsa, OK 74133-5801 | 2009-04-20 |
| 1497908032 | Tamara L Madjid | Nurse Practitioner | 10505 E 91st St, Suite 203, Tulsa, OK 74133-5801 | 2008-10-28 |
| 1144405937 | Kaci Lynn Jackson | Nurse Practitioner | 10505 E 91st St, Ste 208, Tulsa, OK 74133 | 2007-12-31 |
| 1205999638 | Shelby Coleman | Obstetrics & Gynecology | 10505 E 91st St, Tulsa, OK 74133-5801 | 2006-12-18 |
| 1235231069 | Raymattie Singh | Family Medicine | 10505 E 91st St, Tulsa, OK 74133-5801 | 2006-09-02 |
| 1710098108 | Bryan Lucenta Inc | Internal Medicine | 10505 E 91st St, Suite 202, Tulsa, OK 74133-5829 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725058 | Economy Pharmacy | Pharmacy | 10120 E 91st, Tulsa, OK 74133 | 2020-06-24 |
| 1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
| 1003382060 | Carefirst Pharmacy Tulsa, Inc. | Pharmacy | 6214 S. Sheridan Rd, Tulsa, OK 74133 | 2018-10-17 |
| 1003397332 | Adekemi Taiwo | Nurse Practitioner | Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133 | 2018-08-24 |
| 1346732013 | Lauren Nichols | Dentist | 7707 E 111th St Ste 105, Tulsa, OK 74133 | 2018-05-30 |
| 1699264259 | Courtney N Johnson, Pllc | Dentist | 7901 S Sheridan Rd Unit A, Tulsa, OK 74133 | 2018-05-08 |
| 1417464199 | Tulsa Medical and Orthopedic Center PC | Family Medicine | 8165 S Mingo Rd Ste 200, Tulsa, OK 74133 | 2018-01-04 |
| 1013421023 | Susan C. Willard, Do, Pllc | Family Medicine | 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 | 2017-11-29 |
| 1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
| 1477072031 | Amanda Dawn Long | Registered Nurse | 10507 E 91st St Ste 310, Tulsa, OK 74133 | 2017-09-14 |
| Find all providers in zip 74133 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346784683 | Osu Cardiology | Internal Medicine | 802 S Jackson Ave, Suite 225, Tulsa, OK 74127-9015 | 2016-12-06 |
| 1174956890 | Sahil Agrawal | Internal Medicine | 6151 S Yale Ave Ste 100a, Tulsa, OK 74136-1929 | 2013-08-16 |
| 1104180553 | Ajay Joseph | Internal Medicine | 6151 S Yale Ave Ste 1304, Tulsa, OK 74136-1907 | 2012-06-30 |
| 1396004636 | Tucker James Harrison | Internal Medicine | 802 S Jackson Ave Ste 225, Tulsa, OK 74127-9049 | 2012-05-07 |
| 1831333566 | Harsh Chittaranjan Patel | Internal Medicine | 6151 S Yale Ave Ste 1304, Tulsa, OK 74136-1907 | 2009-04-24 |
| 1316005333 | Robert Louis Smith Jr. | Internal Medicine | 9228 S Mingo Rd, Suite 200, Tulsa, OK 74133-5718 | 2006-12-04 |
| 1558372854 | Melvyn Vanroy Mahon | Internal Medicine | 6151 S Yale Ave, Suite 304, Tulsa, OK 74136-1907 | 2006-08-11 |
| 1043272982 | Michael P Carney | Internal Medicine | 802 S Jackson Ave, Suite 500, Tulsa, OK 74127-9015 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710479324 | Parkway H&v | Internal Medicine | 3200 Quail Springs Pkwy Ste 100, Oklahoma City, OK 73134-2698 | 2018-05-31 |
| 1003315946 | Cardiac Cin of Oklahoma City LLC | Internal Medicine | 10601 S Western Ave # 3, Oklahoma City, OK 73170-6201 | 2018-02-06 |
| 1891097358 | Khurram Liaqat | Internal Medicine | 9020 E Reno Ave Ste 200, Midwest City, OK 73130-3336 | 2010-12-03 |
| 1629118740 | Raghav Gupta | Internal Medicine | 5401 N Portland Ave Ste 380, Oklahoma City, OK 73112 | 2007-02-07 |
| 1699886077 | Bryan Allen Lucenta | Internal Medicine | 101 Rockefeller Dr Ste 100, Muskogee, OK 74401-5050 | 2006-08-31 |
| 1811996861 | Grand Lake Regional Cardiology Services LLC | Internal Medicine | 1001 E 18th St, Grove, OK 74344-2907 | 2005-07-20 |
| 1760486484 | Francis H Oliver | Internal Medicine | 731 12th Ave Nw, Ardmore, OK 73401-5761 | 2005-06-09 |
| 1801358981 | Cok Care of Ok, LLC | Internal Medicine | 10601 S Western Ave Ste 3, Oklahoma City, OK 73170-6201 | 2019-04-05 |
| 1447754007 | Rajaram Md Pllc | Internal Medicine | 105 S Bryant Ave, Edmond, OK 73034 | 2018-03-20 |
| 1063850832 | Ssm Healthcare of Ok, Inc | Internal Medicine | 608 Nw 9th St, Suite 4000, Oklahoma City, OK 73102-1068 | 2013-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.