Individual provider Active NPI

Kristin L Sells, PA

  • Physician Assistant
  • Chandler, OK
National Provider Identifier
1497742209
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA742 Issued in OK
Practice address
1116 S. Manvel
Chandler, OK 74834-3856
Phone
(405) 258-5252
Fax
(405) 258-5552
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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 PA742 OK Primary

Addresses

Primary practice location

1116 S. Manvel
Chandler, OK 74834-3856

Mailing address

1116 Manvel Ave
Chandler, OK 74834-3856
Phone (405) 258-5252

Other identifiers 1

IdentifierTypeStateIssuer
100045300CMedicaidOK

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
I20040517000009 OK Practitioner - Physician Assistant 3173513629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1116 Manvel Ave
Chandler, OK 74834-3856
Phone (405) 258-5252

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
742OKMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority Physician Assistant CurrentSince Dec 19, 2019 Accepting new patients
Stillwater Medical Center Authority CurrentSince Dec 19, 2019 Accepting new patients
Stillwater Medical Center Physicians Past Accepting new patients
Mercy Health Network Inc Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

1116 Manvel Ave
Chandler, OK 74834
Phone (405) 258-5252

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

Interoperability endpoints

  • Direct secure messaging: kristin.sells.p1@direct.smc.nextgenshare.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1497742209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 MANVEL AVE",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748343856",
            "telephone_number": "405-258-5252",
            "fax_number": "405-258-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S. MANVEL",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748343856",
            "telephone_number": "405-258-5252",
            "fax_number": "405-258-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLS",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100045300C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, OK

Sources for this page

Verify at the official NPI Registry.