Individual provider Active NPI

Irasema Gipson, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1104056399
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4842 Issued in OK
Practice address
1000 NE 13TH St # 1C
Oklahoma City, OK 73104-5040
Phone
(405) 271-8001
NPI assigned
Jul 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06244 TX
Physician Assistant 363A00000X 4842 OK Primary

Addresses

Primary practice location

1000 NE 13TH St # 1C
Oklahoma City, OK 73104-5040

Mailing address

1000 NE 13TH St
Oklahoma City, OK 73104-5040
Phone (405) 271-8001

Other identifiers 1

IdentifierTypeStateIssuer
297309101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090812000456 TX Practitioner - Physician Assistant 6507910445 Reassigns benefits to 1 organization
I20230519000927 OK Practitioner - Physician Assistant 6507910445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1023 E Cherry St
Suite D Cushing
Cushing, OK 74023-4105
Phone (918) 509-4741

1329 S Sangre Rd
US Dermatology Partners
Stillwater, OK 74074-1854
Phone (405) 533-3376

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4842OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince May 31, 2016 Accepting new patients
Ou Health Partners, Inc CurrentSince Apr 10, 2023 Accepting new patients
Dermatology Associates Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1000 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3445

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

1000 NE 13th St
#1C
Oklahoma City, OK 73104
Phone (405) 271-5963

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

Interoperability endpoints

  • Direct secure messaging: igipson@conger.emadirect.md
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1104056399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045040",
            "telephone_number": "405-271-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NE 13TH ST # 1C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045040",
            "telephone_number": "405-271-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "IRASEMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06244",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297309101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.