Individual provider Active NPI

Billy Grant Sanders, PA

  • Medical Physician Assistant
  • Choctaw, OK
National Provider Identifier
1164597860
Registry record updated Sep 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1561 Issued in OK
Practice address
15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone
(405) 390-9600
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2025

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 1561 OK Primary

Addresses

Primary practice location

15679 NE 23Rd St
Choctaw, OK 73020-8592

Mailing address

PO Box 10
Choctaw, OK 73020-0010
Phone (405) 390-9600

Other identifiers 2

IdentifierTypeStateIssuer
200100040AMedicaidOK
OK400905OtherMEDICARE INDIVIDUAL PTAN

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
I20080804000646 OK Practitioner - Physician Assistant 5395819643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
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)

15679 NE 23Rd St
Choctaw, OK 73020-8592
Phone (405) 390-9600

18961 NE 23Rd St
Harrah, OK 73045-8109
Phone (405) 390-1800

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

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1561OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince May 11, 2022 Accepting new patients
Saints Medical Group, LLC CurrentSince May 11, 2022 Accepting new patients
Choctaw Wellness Enterprises, LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

15679 NE 23rd St
Choctaw, OK 73020
Phone (405) 390-1800

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

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

Interoperability endpoints

  • Direct secure messaging: bsanders43820@direct-ehr-ssmhc.com

Organizations & group practices 6

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 4

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758412800000",
    "number": "1164597860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730200010",
            "telephone_number": "405-390-9600",
            "fax_number": "405-390-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15679 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208592",
            "telephone_number": "405-390-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "BILLY",
        "middle_name": "GRANT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-09-21",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100040A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "OK400905",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Choctaw, OK

Sources for this page

Verify at the official NPI Registry.