Individual provider Active NPI

Steven R O'Dell, P.A. - C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1275556755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1321 Issued in OK
Practice address
4625 S Western Ave
Oklahoma City, OK 73109
Phone
(405) 632-2323
Fax
(405) 631-9315
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1321 OK Primary

Addresses

Primary practice location

4625 S Western Ave
Oklahoma City, OK 73109

Mailing address

PO Box 95818
Oklahoma City, OK 73143-5818
Phone (405) 632-2323

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
I20040611001328 OK Practitioner - Physician Assistant 3274516935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Consultants PCGroup PAC ID 6204723547, 22 clinicians

Practice addresses (Care Compare)

1000 Hospital Cir
Kingfisher, OK 73750-5002
Phone (405) 375-3141

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
86.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1321OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care C Orporation Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275556755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95818",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731435818",
            "telephone_number": "405-632-2323",
            "fax_number": "405-631-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73109",
            "telephone_number": "405-632-2323",
            "fax_number": "405-631-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "P.A. - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.