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NORTHSIDE FAMILY PRACTICE PLLC
NPI 1205103231
Internal Medicine in Tulsa, OK

Active since November 18, 2011
3606 N MARTIN LUTHER KING JR BLVD, TULSA, OK 74106(918) 794-3536(918) 794-7784 Get Directions Write a Review

NPPES record last updated: February 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Northside Family Practice Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHSIDE FAMILY PRACTICE PLLC (NPI 1205103231) is a healthcare organization registered as an internal medicine in Tulsa, Oklahoma and active in the NPI registry since November 2011. The organization lists Prakash George, Cfo, as its authorized official.

NPPES Registry Identity

NPI1205103231
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNORTHSIDE FAMILY PRACTICE PLLC
Location Address3606 N MARTIN LUTHER KING JR BLVDTulsa, OK 74106-6447
Mailing Address3606 N Martin Luther King Jr BlvdTulsa, OK 74106-6447 · (918) 794-3536 · Fax (918) 794-7784
Phone(918) 794-3536
Fax(918) 794-7784
Organization SubpartNo
Authorized OfficialPrakash GeorgeCfo · (918) 704-9408
Enumeration DateNovember 18, 2011
Last NPPES UpdateFebruary 24, 2025
NPPES CertifiedFebruary 24, 2025
✔ NPI 1205103231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3606 N MARTIN LUTHER KING JR BLVD, Tulsa, OK 74106
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northside Family Practice Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Northside Family Practice PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ulysses Bowler, MD
Hospitalist
NPI 1942290788
CORNER OF ROUTE N12 AND N7
Fort Defiance, AZ 86504
(928) 729-8000
✔ PECOS734 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northside Family Practice PLLC's NPI number?

The NPI number for Northside Family Practice PLLC is 1205103231. It was assigned to this organization in the NPPES registry on November 18, 2011.

Where is Northside Family Practice PLLC located?

Northside Family Practice PLLC is located at 3606 N Martin Luther King Jr Blvd, Tulsa, OK 74106. The listed phone number is (918) 794-3536.

What is Northside Family Practice PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Northside Family Practice PLLC enrolled in Medicare?

Yes. Northside Family Practice PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northside Family Practice PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Hospitalist) reassigns their Medicare billing to Northside Family Practice PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Northside Family Practice PLLC was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.