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

Peter Allan Ippoliti

Individual provider Physician Assistant · NPI 1619750015

Peter Allan Ippoliti is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2025, 1 year ago. Practices with Tulsa X-Ray Laboratory PLLC, a 32-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
1
Licensed in
OK
In the registry since
2023
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Practice location Address checks out

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone: (405) 880-8046
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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 5760 (OK)

Record details

NPI number1619750015
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 17, 2023
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026
Mailing address5801 E 41st St Ste 900, Tulsa, OK 74135-5631

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Tulsa X-Ray Laboratory Pllc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Tulsa