Dustin Cupp (NPI# 1417113226, PAC ID# 6800956517) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1417113226 |
| PAC ID by PECOS | 6800956517 |
| Professional Enrollment ID | I20081125000111 |
| Full Name | Dustin Cupp |
| Organization Legal Name | OMNI MEDICAL GROUP INC |
| Address |
1919 S Wheeling Ave Suite 200 Tulsa OK 74104-5631 |
| Phone Number | 9187487600 |
| Gender | M |
| Medical School | OKLAHOMA COLLEGE OF OSTEOPATHIC MEDICINE AND SURGERY |
| Graduation Year | 2007 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9739080490 |
| Number of Group Practice Members | 91 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370114 | ST JOHN MEDICAL CENTER, INC |
| 370091 | SAINT FRANCIS HOSPITAL, INC |
| 370227 | ST JOHN OWASSO |
| 370235 | ST JOHN BROKEN ARROW, INC |
| Address | Phone | Organization |
|---|---|---|
| 1919 S Wheeling Ave, Suite 200, Tulsa, OK 74104-5631 | 9187487600 | OMNI MEDICAL GROUP INC |
| Organization Legal Name | OMNI MEDICAL GROUP INC |
| Physicians | 96 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Goldameir Akingbola | Family Medicine | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Mitzi Blanchard | Nurse Practitioner | Omni Medical Group Inc | 1421 E 13th St, Tulsa, OK 74120-5207 |
| Kelly R Wratten | Nurse Practitioner | Omni Medical Group Inc | 8115 S Memorial Dr, Tulsa, OK 74133-4331 |
| Ana Trujillo | Nurse Practitioner | Omni Medical Group Inc | 4720 S Harvard Ave, Suite 100, Tulsa, OK 74135-3023 |
| Michael H Vu | Family Medicine | Omni Medical Group Inc | 800 W Boise Cir, Suite 160, Broken Arrow, OK 74012-4932 |
| Brian T Crotty | Family Medicine | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| David L Smith | Family Medicine | Omni Medical Group Inc | 13600 E 86th St N, Suite 100, Owasso, OK 74055-8732 |
| Michelle Green | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Monica A Lee | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Patricia Duffy-feins | Clinical Social Worker | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Street Address |
1919 S WHEELING AVE SUITE 200 |
| City | TULSA |
| State | OK |
| Zip | 74104-5631 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul J Gehring | Obstetrics/gynecology | Ob Gyn Specialists of Tulsa Pllc | 1919 S Wheeling Ave, Ste. 700, Tulsa, OK 74104-5636 |
| Justin Worley | Nurse Practitioner | St John Physicians Inc | 1919 S Wheeling Ave, Suite 400, Tulsa, OK 74104-5633 |
| William R Grubb | Internal Medicine | 1919 S Wheeling Ave, Suite 710, Tulsa, OK 74104-5636 | |
| Nicholas Hanna | Cardiovascular Disease (cardiology) | St John Physicians Inc | 1919 S Wheeling Ave, Suite 504, Tulsa, OK 74104-5634 |
| Michael L Hubner | Internal Medicine | 1919 S Wheeling Ave, Suite 108, Tulsa, OK 74104-5637 | |
| Dallas Buck | Nurse Practitioner | St John Physicians Inc | 1919 S Wheeling Ave, Suite 606, Tulsa, OK 74104-5635 |
| Grant R Cox | Obstetrics/gynecology | Ob Gyn Specialists of Tulsa Pllc | 1919 S Wheeling Ave, Ste. 700, Tulsa, OK 74104-5636 |
| Terry Mills | Family Medicine | Omni Medical Group Inc | 1919 S Wheeling Ave, Lower Level 100, Tulsa, OK 74104-5638 |
| Janice Te | Infectious Disease | St John Physicians Inc | 1919 S Wheeling Ave, Suite 404, Tulsa, OK 74104-5634 |
| Jeremy R Salas | Neurology | Neurology LLPc | 1919 S Wheeling Ave, Suite 707, Tulsa, OK 74104-5636 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristin Patrick | Optometry | Oklahoma Vision Development Center | 111 S Lewis Ave, Tulsa, OK 74104-1616 |
| Monte Harrel | Optometry | Oklahoma Vision Development Center | 111 S Lewis Ave, Tulsa, OK 74104-1616 |
| Curtis V Wolf Ii | Ophthalmology | 1145 S Utica Ave, Suite 362, Tulsa, OK 74104-4004 | |
| Kay L Worley | Neurology | Neuro Links of Tulsa, L.L.C. | 1145 S Utica Ave, Suite 901, Tulsa, OK 74104-4005 |
| Gabriela Corsi Vasquez | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Sristi Bhattarai | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Stephan Hambaz | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Zubair Ashraf | Rheumatology | 1145 S Utica Ave, Suite 1109, Tulsa, OK 74104-4010 | |
| Michelle M Pieratt | Anesthesiology | Emergenchealth LLC | 1120 S Utica Ave, Hc Med Ctr, Tulsa, OK 74104-4012 |
| Ivan Kozhulenko | Certified Registered Nurse Anesthetist (crna) | Emergenchealth LLC | 1120 S Utica Ave, Hc Med Ctr, Tulsa, OK 74104-4012 |
| Find all physicians in zip 74104 | |||
| City | TULSA |
| Zip Code | 74104 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TULSA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Dustin Cupp.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.