Individual provider Active NPI

Shea Pelham Pielsticker, MD

  • Emergency Medicine Physician
  • Yukon, OK
National Provider Identifier
1104355718
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33202 Issued in OK
Practice address
709 N Czech Hall Rd
Yukon, OK 73099-7897
Phone
(405) 494-8600
Fax
(405) 494-8600
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33202 OK
Emergency Medicine Physician 207P00000X 33202 OK Primary

Addresses

Primary practice location

709 N Czech Hall Rd
Yukon, OK 73099-7897

Mailing address

709 N Czech Hall Rd
Yukon, OK 73099-7897
Phone (405) 494-8600

Other practice location 1

3025 SW 104th St
Oklahoma City, OK 73159-7036
Phone (405) 300-7740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200722001509 OK Practitioner - Emergency MedicinePractitioner - Family Practice 2769755305 Reassigns benefits to 4 organizations
I20250729001920 AR Practitioner - Emergency Medicine 2769755305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Oklahoma College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Emergency Services, PCGroup PAC ID 8224212949, 57 clinicians
Springdale Bentonville HBP Services LLCGroup PAC ID 1052759263, 88 clinicians
Emergency Services of Oklahoma PCGroup PAC ID 8123209012, 63 clinicians

Practice addresses (Care Compare)

200 2ND Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

4050 W Memorial Rd
Oklahoma City, OK 73120-8382
Phone (405) 608-3200

600 S Monroe St
Enid, OK 73701-7211
Phone (580) 233-2300

Hospital & facility affiliations

  • Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33202OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Midwest City, LLC Emergency Medicine CurrentSince May 1, 2021 Accepting new patients
Springdale- Bentonville HBP Services, LLC Emergency Medicine CurrentSince Jul 17, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 17, 2025 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Sep 15, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 17, 2025 Accepting new patients
Integris Grove Hospital Past Accepting new patients
Integris Miami Hospital Past Accepting new patients
Integris Bass Baptist Health Center Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

100 N 30th St
Clinton, OK 73601
Phone (580) 323-2363

600 S Monroe St
Enid, OK 73701
Phone (580) 233-2300

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

3025 SW 104th St
Oklahoma City, OK 73159
Phone (405) 300-7740

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

900 NE 10th St
#2102
Oklahoma City, OK 73104
Phone (405) 271-2230

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

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

709 N Czech Hall Rd
Yukon, OK 73099
Phone (405) 271-6911

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1104355718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N CZECH HALL RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997897",
            "telephone_number": "405-494-8600",
            "fax_number": "405-494-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N CZECH HALL RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997897",
            "telephone_number": "405-494-8600",
            "fax_number": "405-494-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 SW 104th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731597036",
            "country_code": "US",
            "telephone_number": "405-300-7740",
            "fax_number": "405-300-7731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIELSTICKER",
        "first_name": "SHEA",
        "middle_name": "PELHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "33202",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "33202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.