Individual provider Active NPI

Amber Dawn Haynes, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1073816443
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 230-9000
Fax
(405) 230-9152
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 230-9000

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
I20110509000227 OK Practitioner - Physician Assistant 3678759669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
81.07
Promoting interoperability
86
Improvement activities
40
Cost
69.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1945OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McBride Clinic Orthopedic Hospital, LLC Physician Assistant CurrentSince Feb 1, 2011 Accepting new patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
McBride Clinic Inc Physician Assistant Past Accepting new patients

Locations

1110 N Lee Ave
Oklahoma City, OK 73103
Phone (405) 232-0341

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Interoperability endpoints

  • Direct secure messaging: amber.haynes@moh.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1073816443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9000",
            "fax_number": "405-230-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "AMBER",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.