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

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