Mary Ann Warner Carroll, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5167 Issued in OK

Practice address

1919 S Wheeling Ave Ste 200
Tulsa, OK 74104-5631

Phone

(918) 403-7089

NPI assigned

Aug 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
• Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
• Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment Care Compare group
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment NPD
• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  NPD (past)
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161
  Care Compare affiliation
• St John Sapulpa, Inc.

  • Critical Access Hospital
  • Sapulpa, OK
  • NPI 1922076603
  Care Compare affiliation
• St. John Broken Arrow, Inc

  dba Ascension St. John Jenks

  • General Acute Care Hospital
  • Broken Arrow, OK
  • NPI 1497988596
  Care Compare affiliation

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1295401859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 101ST PL S APT 721",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373542",
            "telephone_number": "918-600-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045631",
            "telephone_number": "918-403-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARY",
        "middle_name": "ANN WARNER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Carroll
• Ian L Carroll, MD
• Jeffrey Colin Carroll, M.D.
• Laura Carroll, ST
• Macy Ann Carroll, OTD, OTR
• Nick Carroll, DO
• Rachel Christine Carroll, DPT
• Deena R Carruthers, LPN
• Jennifer Marie Carsey, MSW
• Daniel Reid Carson

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.