Individual provider Active NPI

Laura Beth Horstkoetter, PA

  • Medical Physician Assistant
  • Norman, OK
National Provider Identifier
1033174032
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1507 Issued in OK
Practice address
334 12TH Ave SE St 110
Norman, OK 73071-5070
Phone
(405) 321-1911
Fax
(405) 321-1610
NPI assigned
Apr 20, 2006
Last updated
Aug 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1507 OK Primary

Addresses

Primary practice location

334 12TH Ave SE St 110
Norman, OK 73071-5070

Mailing address

709 Parkside Rd
Norman, OK 73072-4239
Phone (405) 310-4267

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000514 OK Practitioner - Physician Assistant 3072525146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medok Mustang, LLCGroup PAC ID 7810288032, 11 clinicians

Practice addresses (Care Compare)

12000 Charleston Way
Yukon, OK 73099-9587
Phone (405) 883-1119

1616 S Mustang Rd
Yukon, OK 73099-0304
Phone (405) 256-0501

2804 SW 134TH St
Oklahoma City, OK 73170-5474
Phone (405) 676-8608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1507OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Clinical Associates LLC Past Accepting new patients
Oca MWC LP Past Accepting new patients
Oca 1 LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18065/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/19667/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1033174032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 PARKSIDE RD",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730724239",
            "telephone_number": "405-310-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 12TH AVE SE ST 110",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715070",
            "telephone_number": "405-321-1911",
            "fax_number": "405-321-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORSTKOETTER",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.