Active NPI
Laura Elise Juarez, PA-C
- Surgical Physician Assistant
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 56826
- Practice address
- 1265 S Utica Ave Ste 105
Tulsa, OK 74104-4243 - Phone
- (918) 592-0999
- Fax
- (918) 592-1021
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 000919 | PR | |
| Medical Physician Assistant | 363AM0700X | UT | ||
| Surgical Physician Assistant | 363AS0400X | 4749 | OK | |
| Surgical Physician Assistant | 363AS0400X | 56826 | CA | Primary |
Addresses
Primary practice location
1265 S Utica Ave Ste 105
Tulsa, OK 74104-4243
Mailing address
PO Box 615
Dorado, PR 00646-0615
Phone (801) 362-6791
Other practice location 1
Dr Jose Celso Barbosa Drive
Recinto Ciencias Medicas, UPR
San Juan, PR 00921
Phone (801) 362-6791
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, OK
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56826 | CA | MD | General Practice Dentistry |
| 4749 | OK | MD | Emergency Medicine Physician |
| 000919 | PR | MD | Occupational Therapist |
| 022951 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Integris Cardiovascular Physicians LLC | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
Interoperability endpoints
- ljuarez435964@direct.ynhh.org
- ljuarez1090027@ahs.direct-ci.com
- ljuarez412027@direct-ehr-ssmhc.com
Organizations & group practices 5
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.
-
- Specialist
- Tulsa, OK
- NPI 1780857540
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
- Multi-Specialty Clinic/Center
- Park City, UT
- NPI 1316178478
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Cardiovascular Disease Physician
- Oklahoma City, OK
- NPI 1306129598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1407398639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 615",
"city": "DORADO",
"state": "PR",
"postal_code": "006460615",
"telephone_number": "801-362-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 S UTICA AVE STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741044243",
"telephone_number": "918-592-0999",
"fax_number": "918-592-1021"
}
],
"practiceLocations": [
{
"address_1": "Dr Jose Celso Barbosa Drive",
"address_2": "Recinto Ciencias Medicas, UPR",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "00921",
"country_code": "US",
"telephone_number": "801-362-6791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JUAREZ",
"first_name": "LAURA",
"middle_name": "ELISE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PR",
"license": "000919",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OK",
"license": "4749",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "56826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.