Individual provider Active NPI

Mary E. Pauzauskie, ARNP

  • Family Nurse Practitioner
  • Shawnee, OK
National Provider Identifier
1184675399
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61320 Issued in OK
Practice address
3208 Medical Park Dr
Shawnee, OK 74804-5014
Phone
(405) 878-7160
Fax
(405) 878-7149
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R0061320 OK
Family Nurse Practitioner 363LF0000X 61320 OK Primary

Addresses

Primary practice location

3208 Medical Park Dr
Shawnee, OK 74804-5014

Mailing address

1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 273-2270

Other identifiers 2

IdentifierTypeStateIssuer
200049550BMedicaidOK
200049550AMedicaidOK

Other names 1

  • Mary Elizabeth Ozan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160707001004 TX Practitioner - Nurse Practitioner 6305899600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
61320OKMDFamily Nurse Practitioner
R0061320OKMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince Oct 8, 2022 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Mercy Health Services Inc. Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1184675399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041743",
            "telephone_number": "405-273-2270",
            "fax_number": "405-878-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 MEDICAL PARK DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748045014",
            "telephone_number": "405-878-7160",
            "fax_number": "405-878-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUZAUSKIE",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OK",
            "license": "R0061320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "61320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200049550B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200049550A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "OZAN",
            "middle_name": "ELIZABETH",
            "credential": "CNS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.