Individual provider Active NPI

Riley Bane, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1356163372
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5344 Issued in OK
Practice address
700 NE 13TH St
Oklahoma City, OK 73104-5004
Phone
(470) 040-5271
NPI assigned
Oct 30, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 5344 OK Primary

Addresses

Primary practice location

700 NE 13TH St
Oklahoma City, OK 73104-5004

Mailing address

2548 NW 184TH St
Edmond, OK 73012-0681
Phone (785) 230-6863

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
I20241213000008 OK Practitioner - Physician Assistant 4486180403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Pain Clinic, LLCGroup PAC ID 7214270370, 4 clinicians
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1226 N Shartel Ave
Suite 300
Oklahoma City, OK 73103-2435
Phone (405) 232-8003

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5344OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Nov 15, 2024 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

709 N Czech Hall Rd
Yukon, OK 73099
Phone (405) 271-6911

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1356163372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 NW 184TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730120681",
            "telephone_number": "785-230-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045004",
            "telephone_number": "470-040-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANE",
        "first_name": "RILEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.