Active NPI
Patrick Punchuk Lo, DO
- Family Medicine Physician
- Oklahoma City, OK
National Provider Identifier
1295742039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2288
- Practice address
- 4913 W Reno Ave
Oklahoma City, OK 73127-6339 - Phone
- (405) 948-4900
- Fax
- (405) 948-4933
- NPI assigned
- Aug 2, 2006
- Last updated
- Nov 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2288 | OK | Primary |
Addresses
Primary practice location
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Mailing address
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100047870A | Medicaid | OK |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mychart | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Osteopathic Manipulative Medicine
- Education
- Oklahoma State University College of Osteopathic Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
309 S Ann Arbor
Oklahoma City Indian Clinic
Oklahoma City, OK 73128-1112
Phone (405) 948-4900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Oklahoma American Indian Health Council, Inc. | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
4913 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900
309 S Ann Arbor Ave
Oklahoma City, OK 73128
Phone (405) 948-4900
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.
-
dba Oklahoma City Indian Clinic
- Federally Qualified Health Center (FQHC)
- Oklahoma City, OK
- NPI 1407969728
TX
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Chickasaw Nation Medical Center
- General Acute Care Hospital
- Ada, OK
- NPI 1255364923
-
dba Chickasaw Nation Tishomingo Clinic
- Primary Care Clinic/Center
- Tishomingo, OK
- NPI 1649330242
Hospital
-
dba Chickasaw Nation Ardmore Clinic
- Primary Care Clinic/Center
- Ardmore, OK
- NPI 1730249186
Hospital
-
dba Chickasaw Nation Purcell Clinic
- Primary Care Clinic/Center
- Purcell, OK
- NPI 1982764395
Hospital
-
- Primary Care Clinic/Center
- Ada, OK
- NPI 1962563148
Hospital
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": "1668556800000",
"number": "1295742039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4913 W RENO AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731276339",
"telephone_number": "405-948-4900",
"fax_number": "405-948-4933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4913 W RENO AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731276339",
"telephone_number": "405-948-4900",
"fax_number": "405-948-4933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "PATRICK",
"middle_name": "PUNCHUK",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "2288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100047870A",
"state": "OK"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "mychart",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4913 W Reno Ave",
"city": "Oklahoma City",
"state": "OK",
"country_code": "US",
"postal_code": "731276339",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.