Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Kushnerick, PA-C

Individual provider Surgical Physician Assistant · NPI 1912390238

Kelly Kushnerick, PA-C is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2014, 12 years ago. Practices with Tulsa X-Ray Laboratory Inc, a 30-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
12
Licensed in
OK
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5801 E 41st St Ste 900
Tulsa, OK 74135-5631
Phone: (918) 934-8347
Fax: (918) 743-8552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2536 (OK)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2536 (OK)

Record details

NPI number1912390238
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 11, 2015
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Tulsa X-Ray Laboratory Inc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tulsa