Individual provider Active NPI

Mackenzie Elyse Bellmer, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1477441814
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5588 Issued in OK
Practice address
3366 NW Expwy Ste 800
Oklahoma City, OK 73112-4458
Phone
(405) 948-0640
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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 5588 OK Primary

Addresses

Primary practice location

3366 NW Expwy Ste 800
Oklahoma City, OK 73112-4458

Mailing address

2501 N Blackwelder Ave
Oklahoma City, OK 73106-1402

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
I20251208001511 OK Practitioner - Physician Assistant 6103319173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3366 NW Expressway
Suite 800
Oklahoma City, OK 73112-4458
Phone (405) 713-9935

3366 NW Expwy
Suite 800
Oklahoma City, OK 73112-4458

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5588OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Dec 22, 2025 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3366 NW Expressway St
Ste 800
Oklahoma City, OK 73112
Phone (405) 713-9935

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: mbellmer514856@direct.integrisok.com

Organizations & group practices 2

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 4

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1477441814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N BLACKWELDER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731061402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 NW EXPWY STE 800",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124458",
            "telephone_number": "405-948-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLMER",
        "first_name": "MACKENZIE",
        "middle_name": "ELYSE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.