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BROKEN ARROW PEDIATRICS, LLC
NPI 1265879175
Pediatrics in Broken Arrow, OK

Active since May 31, 2013CLIA 37D0720032 · Waiver
1220 N ELM PL, BROKEN ARROW, OK 74012(918) 258-1955 Get Directions Write a Review

NPPES record last updated: May 31, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Broken Arrow Pediatrics, Llc NPPES

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

BROKEN ARROW PEDIATRICS, LLC (NPI 1265879175) is a healthcare organization registered as a pediatrics in Broken Arrow, Oklahoma and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through October 10, 2026 and lists Carl Erwin Pfanstiel, Owner, as its authorized official.

NPPES Registry Identity

NPI1265879175
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBROKEN ARROW PEDIATRICS, LLC
Location Address1220 N ELM PLBroken Arrow, OK 74012-1616
Mailing Address1220 N Elm PlBroken Arrow, OK 74012-1616 · (918) 258-1955
Phone(918) 258-1955
Organization SubpartNo
Authorized OfficialCarl Erwin PfanstielOwner · (918) 258-1955
Enumeration DateMay 31, 2013
✔ NPI 1265879175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OK · 12938
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1220 N ELM PL, Broken Arrow, OK 74012
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D0720032

Broken Arrow Pediatrics · Broken Arrow, OK
Active · expires Oct 10, 2026
CLIA Number37D0720032
Laboratory TypePhysician Office
Certificate Effective DateOctober 11, 2024
Certificate Expiration DateOctober 10, 2026
Laboratory DirectorCarl E. Pfanstiel
Laboratory Phone(918) 258-1955
Laboratory LocationBroken Arrow Pediatrics1220 N Elm Place, Broken Arrow, OK 74012
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH ARNOLD DNP, APRN-CPNP
Nurse Practitioner (Pediatrics)
1220 N ELM PL
BROKEN ARROW, OK 74012
Tulsa County (918) 237-9515
WHITNEY ROCHELLE KERN FNP
Nurse Practitioner (Family)
1220 N ELM PL
BROKEN ARROW, OK 74012
Tulsa County (918) 258-1955

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 Broken Arrow Pediatrics, LLC's NPI number?

The NPI number for Broken Arrow Pediatrics, LLC is 1265879175. It was assigned to this organization in the NPPES registry on May 31, 2013.

Where is Broken Arrow Pediatrics, LLC located?

Broken Arrow Pediatrics, LLC is located at 1220 N Elm Pl, Broken Arrow, OK 74012. The listed phone number is (918) 258-1955.

What is Broken Arrow Pediatrics, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Broken Arrow Pediatrics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D0720032) is associated with this NPI, valid through October 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Broken Arrow Pediatrics, LLC was last updated on May 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.