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OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC
NPI 1427279561
Physical Medicine & Rehabilitation - Pain Medicine in Broken Arrow, OK

Active since May 02, 2007
1621 S EUCALYPTUS AVE, SUITE 204, BROKEN ARROW, OK 74012(918) 252-7952 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Oklahoma Physical Medicine And Rehabilitation, Pc NPPES

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

OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC (NPI 1427279561) is a healthcare organization registered as a pain medicine in Broken Arrow, Oklahoma and active in the NPI registry since May 2007. The organization lists Timothy G Pettingell, Physician, as its authorized official.

NPPES Registry Identity

NPI1427279561
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameOKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC
Location Address1621 S EUCALYPTUS AVE, SUITE 204Broken Arrow, OK 74012-5940
Mailing Address10026 S Mingo Rd Ste A, Pmb 234Tulsa, OK 74133-5717 · (918) 252-7952
Phone(918) 252-7952
Organization SubpartNo
Authorized OfficialTimothy G PettingellPhysician · (918) 252-7952
Enumeration DateMay 2, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1427279561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

1621 S EUCALYPTUS AVE, Broken Arrow, OK 74012
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Other Identifiers 1

Other434452335005OK · Blue Cross Blue Shield

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 37D1072715

Oklahoma Cosmetic Surgery Center, PC · Tulsa, OK
Active · expires Aug 21, 2027
CLIA Number37D1072715
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 22, 2025
Certificate Expiration DateAugust 21, 2027
Laboratory DirectorAngelo Cuzalina, MD, Dds
Laboratory Phone(918) 392-0880
Laboratory LocationOklahoma Cosmetic Surgery Center, PC7322 E 91st St, Tulsa, OK 74133
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 37D1076270

Oklahoma Heart Institute · Tulsa, OK
Expired · Nov 7, 2025
CLIA Number37D1076270
Laboratory TypePhysician Office
Certificate Effective DateNovember 8, 2023
Certificate Expiration DateNovember 7, 2025
Laboratory DirectorWayne N. Leimbach, MD
Laboratory Phone(918) 592-0999
Laboratory LocationOklahoma Heart Institute9228 S Mingo Rd #200 Attn Becky Such, Tulsa, OK 74133
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

MISS KARLA HOBART PT, DPT, OCS
Physical Therapist (Orthopedic)
1621 S EUCALYPTUS AVE
BROKEN ARROW, OK 74012
Tulsa County (918) 252-0513
DR. MYRNA BYERS DOMONEY D.D.S.
Dentist (General Practice)
1621 S EUCALYPTUS AVE, SUITE 101
BROKEN ARROW, OK 74012
Tulsa County (918) 250-0624
DR. KEVIN C. DUFFY D.D.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
1621 S EUCALYPTUS AVE, STE 201
BROKEN ARROW, OK 74012
Tulsa County (918) 249-1818
MELISSA MORGAN MD PC
Clinic/Center (Health Service)
1621 S EUCALYPTUS AVE, SUITE 202
BROKEN ARROW, OK 74012
Tulsa County (918) 459-7546

Frequently Asked Questions

What is OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC's NPI number?

The NPI number assigned to this healthcare provider is 1427279561, enumerated as an "organization" on May 02, 2007.

Where is the provider located?

The provider is located at 1621 S EUCALYPTUS AVE SUITE 204 BROKEN ARROW, OK 74012 and the phone number is (918) 252-7952.

What is the provider's specialty?

Physical Medicine & Rehabilitation with taxonomy code 2081P2900X and a focus in Pain Medicine.

What insurance does OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC accept?

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.