OrganizationActive
Active Lifestyle Medical, LLC
NPI 1902370885 · Durable Medical Equipment & Medical Supplies · Tulsa, OK
Provider details
- NPI number
- 1902370885
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Robbie Ely, President(918) 520-8008
Specialties & taxonomies
Suppliers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5455 S Mingo Rd Ste E
Tulsa, OK 74146-5724
Phone: (918) 576-6765
Fax: (888) 605-4113
Street-level locationGet directions
Mailing address
5455 S Mingo Rd Ste E
Tulsa, OK 74146-5724
Additional practice locations (1)
- 8740 E 11th St Ste DTulsa, OK 74112-7957Phone: (918) 520-8008Fax: (918) 928-4458
Registry dates
- Enumerated
- 2019-01-14
- Last updated
- 2022-05-18
- Certified
- 2022-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.