Individual provider Active NPI

Prince William Taylor, P.A.

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1275586315
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1121 Issued in OK
Practice address
5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone
(405) 604-6000
NPI assigned
May 18, 2006
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 PA1121 OK Primary

Addresses

Primary practice location

5501 N Portland Ave
Oklahoma City, OK 73112-2074

Mailing address

3115 NW 21St St
Oklahoma City, OK 73107-3009

Other identifiers 1

IdentifierTypeStateIssuer
100096360AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ptaylor127433@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MD, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20101108001470 FL Practitioner - Physician Assistant 3971400771 Reassigns benefits to 4 organizations
I20250218000373 MD Practitioner - Physician Assistant 3971400771 Reassigns benefits to 1 organization
I20250729004006 VA Practitioner - Physician Assistant 3971400771 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1121OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 1, 2025 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jan 26, 2025 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Nov 12, 2012 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince Nov 12, 2012 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 1, 2025 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jan 26, 2025 Accepting new patients
Norstar Emergency Physicians Past Accepting new patients
Seminole Health Center LLC Past Accepting new patients
Lightstar Emergency Physicians, PLLC Past Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

Interoperability endpoints

  • Direct secure messaging: ptaylor127433@mhsdirect.net

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1275586315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 NW 21ST ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731073009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122074",
            "telephone_number": "405-604-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "PRINCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA1121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096360A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptaylor127433@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "7800 Sheridan St",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330242536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.