Individual provider Active NPI

Emily Weber

  • Surgical Physician Assistant
  • Muskogee, OK
National Provider Identifier
1386295558
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4534 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(918) 577-3000
Fax
(918) 577-3677
NPI assigned
Sep 27, 2019
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4534 OK Primary

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone (918) 577-3000

Other practice location 1

1919 S Wheeling Ave Ste 600
Tulsa, OK 74104
Phone (918) 619-4400

Other practice location 2

1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041
Phone (918) 579-5749

Other identifiers 1

IdentifierTypeStateIssuer
200960190AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4534OKMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morad El-Raheb MD Inc PC CurrentSince Feb 17, 2021 Accepting new patients

Locations

1145 S Utica Ave
Ste 1105
Tulsa, OK 74104
Phone (918) 579-5724

1145 S Utica Ave
Ste 460
Tulsa, OK 74104
Phone (918) 392-8884

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, 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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1386295558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3000",
            "fax_number": "918-577-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3000",
            "fax_number": "918-577-3677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 S Wheeling Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74104",
            "country_code": "US",
            "telephone_number": "918-619-4400",
            "fax_number": "918-634-7560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1145 S Utica Ave Ste 460",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741044041",
            "country_code": "US",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBER",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "4534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200960190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.