NPIMap

Individual provider Active NPI

Andrea Fraley, MD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Edmond, OK
National Provider Identifier
1487660585
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
26519 Issued in OK
Practice address
2017 W I 35 Frontage Rd
Suite 130
Edmond, OK 73013-8504
Phone
(405) 757-3630
Fax
(405) 757-3631
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 26519 OK
Physical Medicine & Rehabilitation Physician 208100000X 036-115728 IL
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 26519 OK Primary

Addresses

Primary practice location

2017 W I 35 Frontage Rd
Suite 130
Edmond, OK 73013-8504

Mailing address

925 W I 35 Frontage Rd Ste 100
Edmond, OK 73034-7399
Phone (405) 471-5460

Other identifiers 1

IdentifierTypeStateIssuer
036115728MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000334 OK Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 4082612783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fraley Clinic PLLCGroup PAC ID 5294001962, 3 clinicians

Practice addresses (Care Compare)

1301 W 6TH Ave
Suite 207
Stillwater, OK 74074-4381
Phone (405) 533-6990

925 W I 35 Frontage Rd
Suite 100
Edmond, OK 73034-7399
Phone (405) 471-5460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.02 of 100Reported as individual
Quality
80.15
Promoting interoperability
90
Improvement activities
40
Cost
82.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-115728ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Dec 1, 2020 Accepting new patients
Stillwater Medical Center Authority CurrentSince Dec 1, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Physicians Past Accepting new patients

Locations

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

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

1301 W 6th Ave
Ste 207
Stillwater, OK 74074
Phone (405) 533-3010

Interoperability endpoints

  • Direct secure messaging: andrea.fraley.p1@direct.smc.nextgenshare.com
  • Direct secure messaging: andrea.fraley.1@16518.direct.athenahealth.com

Organizations & group practices 6

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 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1487660585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W I 35 FRONTAGE RD STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347399",
            "telephone_number": "405-471-5460",
            "fax_number": "405-471-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD",
            "address_2": "SUITE 130",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138504",
            "telephone_number": "405-757-3630",
            "fax_number": "405-757-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "ANDREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "26519",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-115728",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OK",
            "license": "26519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115728",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.