NPIMap

Individual provider Active NPI

Mark C Leu, PA-C

  • Medical Physician Assistant
  • Ada, OK
National Provider Identifier
1376538744
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00722 Issued in OK
Practice address
1414 Arlington St
Suite 2300
Ada, OK 74820-2643
Phone
(580) 332-0112
Fax
(580) 332-1005
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00722 OK Primary

Addresses

Primary practice location

1414 Arlington St
Suite 2300
Ada, OK 74820-2643

Mailing address

1414 Arlington St
Suite 2300
Ada, OK 74820-2643
Phone (580) 332-0112

Other identifiers 1

IdentifierTypeStateIssuer
100131200AMedicaidOK

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
I20110120000054 OK Practitioner - Physician Assistant 9830378025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oklahoma Urology, IncGroup PAC ID 2961464730, 2 clinicians

Practice addresses (Care Compare)

1414 Arlington St
Suite 2300
Ada, OK 74820-2694
Phone (580) 332-0112

430 N Monte Vista St
Ada, OK 74820-4610
Phone (580) 332-0112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.46 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
722OKMDPhysical Therapy Assistant
PA00722OKMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mleu@soui-ok.direct.office.nextgen.com
  • Direct secure messaging: mleu@soku.mdlogic.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1376538744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 ARLINGTON ST",
            "address_2": "SUITE 2300",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202643",
            "telephone_number": "580-332-0112",
            "fax_number": "580-332-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 ARLINGTON ST",
            "address_2": "SUITE 2300",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202643",
            "telephone_number": "580-332-0112",
            "fax_number": "580-332-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEU",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA00722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.