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

Mr. Shane Brody Hnatusko, MSIV

Individual provider Emergency Medicine Physician · NPI 1407215460

Mr. Shane Brody Hnatusko, MSIV is an Emergency Medicine in Tulsa, Oklahoma. Qualified in 2016, 10 years ago. Practices with Northeastern Health System, a 104-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
10
Licensed in
KS
In the registry since
2016
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Practice location Address checks out

744 W 9th St Emergency Medicine Dept
Tulsa, OK 74127-9020
Phone: (918) 599-5100
Fax: (918) 599-5065
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 05-40483 (KS)

Record details

NPI number1407215460
Entity typeIndividual (Type 1)
GenderMale
Credentials MSIV
Sole proprietorNo
NPI enumeratedFebruary 18, 2016
Last updated in NPPESMay 31, 2019

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Northeastern Health System — 104 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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