AGE ERASE MEDICAL AESTHETICS
NPI 1386505709
Nurse Practitioner in Tulsa, OK

Q: What is Age Erase Medical Aesthetics's NPI number?

The NPI number for Age Erase Medical Aesthetics is 1386505709. It was assigned to this organization in the NPPES registry on November 24, 2025.

Q: What is Age Erase Medical Aesthetics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since November 24, 2025

7010 S UTICA AVE, TULSA, OK 74136(940) 704-1700 Get Directions Write a Review

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 4, 2026, Dec 24, 2025, Nov 24, 2025 (3 updates tracked since 2025).

On this page

About Age Erase Medical Aesthetics NPPES

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

AGE ERASE MEDICAL AESTHETICS (NPI 1386505709) is a healthcare organization registered as a nurse practitioner in Tulsa, Oklahoma and active in the NPI registry since November 2025. The organization lists Reesey Russell, Owner, as its authorized official.

NPPES Registry Identity

NPI1386505709

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameAGE ERASE MEDICAL AESTHETICS

Location Address7010 S UTICA AVETulsa, OK 74136-3907

Mailing Address7010 S Utica AveTulsa, OK 74136-3907 · Fax (918) 890-4133

Phone(940) 704-1700

Organization SubpartNo

Authorized OfficialReesey RussellOwner · (940) 704-1700

Enumeration DateNovember 24, 2025

Last NPPES UpdateMarch 4, 20263 updates tracked since enumeration

NPPES CertifiedMarch 4, 2026

✔ NPI 1386505709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

7010 S UTICA AVE, Tulsa, OK 74136

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Age Erase Medical Aesthetics 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 Age Erase Medical Aesthetics, which bills Medicare for the services this clinician delivers.

Clinician (1)

Reesey Russell, FNP-C

Nurse Practitioner

NPI 1013726991

7010 S UTICA AVE
Tulsa, OK 74136

(940) 704-1700

✔ PECOS✔ Accepts MedicareSame address

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 Age Erase Medical Aesthetics's NPI number?

The NPI number for Age Erase Medical Aesthetics is 1386505709. It was assigned to this organization in the NPPES registry on November 24, 2025.

Where is Age Erase Medical Aesthetics located?

Age Erase Medical Aesthetics is located at 7010 S Utica Ave, Tulsa, OK 74136. The listed phone number is (940) 704-1700.

What is Age Erase Medical Aesthetics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Age Erase Medical Aesthetics enrolled in Medicare?

Yes. Age Erase Medical Aesthetics is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Age Erase Medical Aesthetics?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Age Erase Medical Aesthetics. 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.

What insurance does Age Erase Medical Aesthetics accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Age Erase Medical Aesthetics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Age Erase Medical Aesthetics was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.