Individual provider Active NPI

Samantha Phoua Vang-Cheng, DO

  • Family Medicine Physician
  • Owasso, OK
National Provider Identifier
1497011563
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5642 Issued in OK
Practice address
12455 E 100TH St N Ste 190
Owasso, OK 74055-4675
Phone
(918) 274-5509
NPI assigned
Apr 3, 2012
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5642 OK Primary

Addresses

Primary practice location

12455 E 100TH St N Ste 190
Owasso, OK 74055-4675

Mailing address

12455 E 100TH St N
Ste 190
Owasso, OK 74055-4675
Phone (918) 403-7054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160819000279 OK Practitioner - Family Practice 6002101789 Reassigns benefits to 2 organizations
I20180726000777 TX Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6002101789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Aug 5, 2018 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 25, 2016 Accepting new patients
Omni Medical Group Inc Family Medicine CurrentSince Jun 2, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
St. John Physicians, Inc. Family Medicine CurrentSince Jul 25, 2016 Accepting new patients
Cherokee Nation CurrentSince Aug 5, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

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

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: svangcheng714481@directa.mercy.net

Organizations & group practices 9

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1497011563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N",
            "address_2": "STE 190",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-403-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 190",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-274-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG-CHENG",
        "first_name": "SAMANTHA",
        "middle_name": "PHOUA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.