Individual provider Active NPI

Melissa N Moore-Colvert, PA

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1447555628
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1976 Issued in OK
Practice address
3201 N Van Buren St Ste 350
Enid, OK 73703-1814
Phone
(580) 366-0844
Fax
(580) 297-5197
NPI assigned
Jan 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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 1976 OK Primary

Addresses

Primary practice location

3201 N Van Buren St Ste 350
Enid, OK 73703-1814

Mailing address

3201 N Van Buren St Ste 350
Enid, OK 73703-1814
Phone (580) 366-0844

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherOKMEDICARE PTAN

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
I20110516000164 OK Practitioner - Physician Assistant 0345426086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Health Clinic PLLCGroup PAC ID 5597070326, 23 clinicians

Practice addresses (Care Compare)

3200 Quail Springs Pkwy
Suite 200
Oklahoma City, OK 73134-2699
Phone (405) 241-3539

Hospital & facility affiliations

  • Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
  • St Mary'S Regional Medical Center Hospital, Enid, OK, CCN 370026

Merit-based Incentive Payment System (MIPS)

Final score
79.24 of 100Reported as group
Quality
59.04
Promoting interoperability
97
Improvement activities
40
Cost
74.25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 1, 2014 Accepting new patients
Allergy Partners, PLLC Past Accepting new patients
St. John Physicians, Inc. Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

Interoperability endpoints

  • Direct secure messaging: melissa.colvert.1@23723.direct.athenahealth.com
  • Direct secure messaging: melissa.colvert.p1@direct.ahgcardiology.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1447555628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 N VAN BUREN ST STE 350",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737031814",
            "telephone_number": "580-366-0844",
            "fax_number": "580-297-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 N VAN BUREN ST STE 350",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737031814",
            "telephone_number": "580-366-0844",
            "fax_number": "580-297-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-COLVERT",
        "first_name": "MELISSA",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PENDING",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.