Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dylan Johnston

Individual provider Physician Assistant · NPI 1609594787

Dylan Johnston is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2024, 2 years ago. Practices with Integris Ambulatory Care Corporation, a 683-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1111 W 17th St
Tulsa, OK 74107-1886
Phone: (918) 561-1145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1609594787
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 16, 2022
Last updated in NPPESAugust 16, 2022
Certification dateAugust 16, 2022
Mailing address17765 W Triplett Rd, Cashion, OK 73016-9694

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Integris Ambulatory Care Corporation — 683 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tulsa