NPIMap

Individual provider Active NPI

Mandi Brooke Rhodes, PA-C

  • Medical Physician Assistant
  • Moore, OK
National Provider Identifier
1114153293
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1836 Issued in OK
Practice address
1400 SE 4TH St
Ste H
Moore, OK 73160-7329
Phone
(405) 799-7400
Fax
(405) 799-7405
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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 1836 OK Primary

Addresses

Primary practice location

1400 SE 4TH St
Ste H
Moore, OK 73160-7329

Mailing address

1400 SE 4TH St
Ste H
Moore, OK 73160-7329
Phone (405) 799-7400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mandi.rhodes.1@4696.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110525000594 OK Practitioner - Physician Assistant 0042496192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

3345 Territory LN
El Reno, OK 73036-6503
Phone (405) 218-2530

608 NW 9TH St
Oklahoma City, OK 73102-1049

828 SW 4TH St
Moore, OK 73160-2413
Phone (405) 799-7400

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1836OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Apr 1, 2021 Accepting new patients
Saints Medical Group, LLC CurrentSince Apr 1, 2021 Accepting new patients
Moore Primary Care Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc Past Accepting new patients
Moore Primary Care Geriatrics Aprn-CNP, PC PastSince Aug 24, 2014 Accepting new patients

Locations

1400 SE 4th St
Ste H
Moore, OK 73160
Phone (405) 790-0300

1400 SE 4th St
Ste C
Moore, OK 73160
Phone (405) 799-7400

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

6201 N Santa Fe Ave
Ste 1010
Oklahoma City, OK 73118
Phone (405) 772-8687

777 NW 63rd St
Fl 4
Oklahoma City, OK 73116
Phone (405) 231-3818

Interoperability endpoints

  • Direct secure messaging: mrhodes391957@direct-ehr-ssmhc.com

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.

Hospital & facility affiliations 9

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1114153293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SE 4TH ST",
            "address_2": "STE H",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731607329",
            "telephone_number": "405-799-7400",
            "fax_number": "405-799-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SE 4TH ST",
            "address_2": "STE H",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731607329",
            "telephone_number": "405-799-7400",
            "fax_number": "405-799-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "MANDI",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mandi.rhodes.1@4696.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1400 SE 4th St",
            "address_2": "STE H",
            "city": "Moore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731607329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.