Active NPI
Sumali M Fernando, PSY.D.
- Psychologist
- Oklahoma City, OK
National Provider Identifier
1013058817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1214
- Practice address
- 3035 NW 63Rd St
Suite 227
Oklahoma City, OK 73116-3632 - Phone
- (405) 849-6173
- Fax
- (405) 544-5916
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1214 | OK | Primary |
Addresses
Primary practice location
3035 NW 63Rd St
Suite 227
Oklahoma City, OK 73116-3632
Mailing address
3035 NW 63Rd St
Suite 227
Oklahoma City, OK 73116-3632
Phone (817) 681-9839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3035 NW 63Rd St
Oklahoma City, OK 73116-3631
Phone (405) 242-6460
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1214 | OK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sumali Fernando LLC | Current | Accepting new patients |
Locations
3035 NW 63rd St
Ste 227
Oklahoma City, OK 73116
Phone (405) 242-6460
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Oklahoma City, OK
- NPI 1669913117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1013058817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3035 NW 63RD ST",
"address_2": "SUITE 227",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731163632",
"telephone_number": "817-681-9839",
"fax_number": "405-544-5916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3035 NW 63RD ST",
"address_2": "SUITE 227",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731163632",
"telephone_number": "405-849-6173",
"fax_number": "405-544-5916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDO",
"first_name": "SUMALI",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "1214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.