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

Individual provider Internal Medicine Physician · NPI 1639306293

Pavankumar Bommasamudram, MD is a Hospitalist in Tulsa, Oklahoma. Qualified in 2008, 18 years ago. Practices with Cherokee Nation, a 448-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Kansas and Oklahoma.

Years since qualifying
18
Licensed in
KS, OK
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1705 E 19th St Ste #302
Tulsa, OK 74104-5405
Phone: (918) 748-7585
Fax: (918) 748-7539
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 27309 (OK)
Internal Medicine Physician Taxonomy 207R00000X · Licence 04-41542 (KS)

Record details

NPI number1639306293
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 22, 2009
Last updated in NPPESDecember 5, 2018
Mailing address1705 E 19th St, Ste #302, Tulsa, OK 74104

Medicare enrollment

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

Medicare specialtyHOSPITALIST
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Cherokee Nation — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations12 on file with Medicare

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