NPIMap

Individual provider Active NPI

Susan D Worsham, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1245233113
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3300 NW Expressway FL 2
Oklahoma City, OK 73112-4418
Phone
(405) 949-3417
Fax
(405) 552-5165
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

3300 NW Expressway FL 2
Oklahoma City, OK 73112-4418

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (405) 949-3417

Other identifiers 2

IdentifierTypeStateIssuer
100107320AMedicaidOK
P00145015OtherOKRAILROAD MEDICARE

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
I20040713001519 OK Practitioner - Physician Assistant 9537147699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care Corporation 687 clinicians
Ibmc ER Physicians 16 clinicians

Practice addresses (Care Compare)

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3141

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
719OKMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Mar 1, 2026 Accepting new patients
Advanced Imaging LLC Past Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3433 NW 56th St
Ste C10
Oklahoma City, OK 73112
Phone (405) 945-4740

3300 NW Expressway St
Fl 2
Oklahoma City, OK 73112
Phone (405) 251-2815

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

Interoperability endpoints

  • Direct secure messaging: sworsham40423@direct.integrisok.com

Organizations & group practices 4

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 5

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1245233113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-949-3417",
            "fax_number": "405-552-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY FL 2",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3417",
            "fax_number": "405-552-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSHAM",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100107320A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00145015",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.