Individual provider Active NPI

Allen J Leimenstoll, PA-C

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1457342776
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1350 Issued in OK
Practice address
600 S Monroe St
Enid, OK 73701-7211
Phone
(580) 233-9310
Fax
(580) 548-1489
NPI assigned
Nov 4, 2005
Last updated
May 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1350 OK Primary
Physician Assistant 363A00000X TX

Addresses

Primary practice location

600 S Monroe St
Enid, OK 73701-7211

Mailing address

600 S Monroe St
Enid, OK 73701-7211
Phone (580) 233-2300

Other practice location 1

501 N 14th St
Perry, OK 73077-5021
Phone (580) 336-3541

Other practice location 2

710 S 13th St
Blackwell, OK 74631-3700
Phone (580) 363-9354

Other identifiers 1

IdentifierTypeStateIssuer
200037520AMedicaidOK

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
I20040713000577 OK Practitioner - Physician Assistant 8426036658 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1350OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Mar 1, 2020 Accepting new patients
Stillwater Medical Center Authority Physician Assistant CurrentSince Mar 1, 2020 Accepting new patients
Panhandle Womens Center P L L C Past Accepting new patients

Locations

706 S 13th St
Ste C
Blackwell, OK 74631
Phone (580) 363-2311

710 S 13th St
Blackwell, OK 74631
Phone (580) 363-2311

501 N 14th St
Perry, OK 73077
Phone (580) 336-3541

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

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, 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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1457342776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MONROE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017211",
            "telephone_number": "580-233-2300",
            "fax_number": "580-548-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MONROE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017211",
            "telephone_number": "580-233-9310",
            "fax_number": "580-548-1489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N 14th St",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "OK",
            "postal_code": "730775021",
            "country_code": "US",
            "telephone_number": "580-336-3541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 S 13th St",
            "address_purpose": "LOCATION",
            "city": "Blackwell",
            "state": "OK",
            "postal_code": "746313700",
            "country_code": "US",
            "telephone_number": "580-363-9354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIMENSTOLL",
        "first_name": "ALLEN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1350",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200037520A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.