Ivan Wayne, MD

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

22995 Issued in OK

Practice address

10001 Broadway Ext Ste a
Oklahoma City, OK 73114-6307

Phone

(405) 748-5950

Fax

(405) 607-3580

NPI assigned

Mar 14, 2006

Last updated

Jan 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

University of Iowa, RJ & L Carver College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• W Professional Surgical Services PLLC

  dba W Aesthetics

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Oklahoma City, OK
  • NPI 1861205379
  Medicare reassignment NPD Authorized official
• W Medical Services

  dba W Aesthetics

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Oklahoma City, OK
  • NPI 1912717711
  NPD Authorized official
• Oklahoma Otolaryngology Associates, LLC

  • Specialist
  • Oklahoma City, OK
  • NPI 1124118773
  NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Oklahoma Otolaryngology Hearing Center Inc

  dba Oklahoma Hearing Center

  • Audiologist
  • Edmond, OK
  • NPI 1356788954
  NPD (past)

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

• SSM Health Care of Oklahoma Inc

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc.

  dba SSM Health St. Anthony Hospital - Oklahoma City

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1134198260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6608 N WESTERN AVE # 416",
            "city": "NICHOLS HILLS",
            "state": "OK",
            "postal_code": "731167326",
            "telephone_number": "405-748-5950",
            "fax_number": "405-607-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 BROADWAY EXT STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146307",
            "telephone_number": "405-748-5950",
            "fax_number": "405-607-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "22995",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "OK",
            "license": "22995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Elisabeth Wayland, DNP-APRN
• Samantha Wayland, BA
• Larson M Wayman, D.D.S.
• Misty L Wayman, MD
• Waymon D. Harrison, O.D. P.C.
• Kayla Wazny
• We Care LLC (We Care Home Health)
• We Care LLC
• We Care LLC
• We Care Wheel Chair LLC

• Facial Plastic Surgery Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Facial Plastic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.