Organization Active NPI

Urology Specialists of Central Oklahoma, LLC

  • Urology Physician
  • Oklahoma City, OK
National Provider Identifier
1356612063
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY SPECIALISTS OF CENTRAL OKLAHOMA, LLC
Practice address
5401 N. Portland Ave. Suite 440
Oklahoma City, OK 73112
Phone
(405) 943-1137
Fax
(405) 947-0731
NPI assigned
Jan 26, 2012
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
En Shea Samara, MD
Title
Managing Partner
Phone
(405) 943-1137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X OK Primary

Addresses

Primary practice location

5401 N. Portland Ave. Suite 440
Oklahoma City, OK 73112

Mailing address

5401 N. Portland Ave. Suite 440
Oklahoma City, OK 73112
Phone (405) 943-1137

Other identifiers 1

IdentifierTypeStateIssuer
200438780AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120615000549 OK Part B Supplier - Clinic/Group Practice 0042474371 Receives reassigned benefits from 7 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory
Tax ID family
Urology SPCS of Cntrl Ok2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3366 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 943-1137

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1356612063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N. PORTLAND AVE. SUITE 440",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73112",
            "telephone_number": "405-943-1137",
            "fax_number": "405-947-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N. PORTLAND AVE. SUITE 440",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73112",
            "telephone_number": "405-943-1137",
            "fax_number": "405-947-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY SPECIALISTS OF CENTRAL OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "SAMARA",
        "authorized_official_first_name": "EN",
        "authorized_official_middle_name": "SHEA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "405-943-1137",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200438780A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "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 Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.