Individual provider Active NPI

Phoay Luan Lee, PA-C

  • Physician Assistant
  • Norman, OK
National Provider Identifier
1154866747
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2700 Issued in OK
Practice address
909 Alameda St
Norman, OK 73071-5229
Phone
(405) 360-5100
NPI assigned
Jan 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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 2700 OK Primary

Addresses

Primary practice location

909 Alameda St
Norman, OK 73071-5229

Mailing address

PO Box 400
Norman, OK 73070-0400
Phone (405) 360-5100

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
I20170327002865 OK Practitioner - Physician Assistant 5991080384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of OklahomaGroup PAC ID 4486558962, 99 clinicians

Practice addresses (Care Compare)

909 Alameda St
Norman, OK 73071-5229
Phone (405) 360-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2700OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma CurrentSince Apr 22, 2023 Accepting new patients
State of Oklahoma CurrentSince Apr 22, 2023 Accepting new patients

Locations

909 Alameda St
Norman, OK 73071
Phone (405) 573-3812

2323 S Harvard Ave
Tulsa, OK 74114
Phone (918) 293-2140

Organizations & group practices 2

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1154866747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730700400",
            "telephone_number": "405-360-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ALAMEDA ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715229",
            "telephone_number": "405-360-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PHOAY LUAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.