Individual provider Active NPI

Ami L Siems, M.D.

  • Family Medicine Physician
  • Yukon, OK
National Provider Identifier
1255348306
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16964 Issued in OK
Practice address
1491 Health Center Parkway
Yukon, OK 73099-6767
Phone
(405) 806-2200
Fax
(405) 806-2207
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16964 OK Primary

Addresses

Primary practice location

1491 Health Center Parkway
Yukon, OK 73099-6767

Mailing address

1491 Health Center Parkway
Yukon, OK 73099-6767
Phone (405) 806-2200

Other identifiers 2

IdentifierTypeStateIssuer
200025260AMedicaidOK
P00035684OtherOKRAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000090 OK Practitioner - Family Practice 5597714501 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16964OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aquilo Health Company P C Dba Canadian Valley Family Care Family Medicine CurrentSince Jul 1, 2003 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1491 Health Center Pkwy
Yukon, OK 73099
Phone (405) 806-2200

Interoperability endpoints

  • Direct secure messaging: ami.siems.1@25216.direct.athenahealth.com

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1255348306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 HEALTH CENTER PARKWAY",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996767",
            "telephone_number": "405-806-2200",
            "fax_number": "405-806-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 HEALTH CENTER PARKWAY",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996767",
            "telephone_number": "405-806-2200",
            "fax_number": "405-806-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMS",
        "first_name": "AMI",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200025260A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00035684",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.