NPIMap

Individual provider Active NPI

Paul L. Plusquellec Jr., M.D.

  • Internal Medicine Physician
  • Norman, OK
National Provider Identifier
1295727089
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19357 Issued in OK
Practice address
950 N Porter Ave
Suite 300
Norman, OK 73071
Phone
(405) 329-0121
Fax
(405) 292-6099
NPI assigned
Aug 17, 2005
Last updated
May 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19357 OK Primary

Addresses

Primary practice location

950 N Porter Ave
Suite 300
Norman, OK 73071

Mailing address

950 N Porter Ave
Suite 300
Norman, OK 73071-6400
Phone (405) 329-0121

Other identifiers 3

IdentifierTypeStateIssuer
110111738OtherOKRAILROAD MEDICARE
4645705OtherOKAETNA EDI
100083760AMedicaidOK

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
I20101018000092 OK Practitioner - Internal Medicine 1557390275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisville Medical College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

950 N Porter Ave
200 Mercy Clinic Primary Care Norman
Norman, OK 73071-6400
Phone (405) 329-0121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19357OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Apr 15, 2017 Accepting new patients
Summit Medical Center Past Accepting new patients
Ignite Medical Resort Norman, LLC Past Accepting new patients

Locations

950 N Porter Ave
Ste 200
Norman, OK 73071

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • Direct secure messaging: pplusquellec805485@directc.mercy.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ignite Medical Resort Norman, LLCNorman, OK, CCN 375461 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2020
Mar 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 6

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1295727089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N PORTER AVE",
            "address_2": "SUITE 300",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716400",
            "telephone_number": "405-329-0121",
            "fax_number": "405-292-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N PORTER AVE",
            "address_2": "SUITE 300",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73071",
            "telephone_number": "405-329-0121",
            "fax_number": "405-292-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUSQUELLEC",
        "first_name": "PAUL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "19357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110111738",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA EDI",
            "identifier": "4645705",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100083760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.