Elizabeth Oakley Haak, PA-C
Individual provider Active NPI Physician Assistant · Prague, OK
NPI 1508464686 · NPPES record last updated Oct 12, 2020
Key facts
- NPI
- 1508464686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 3213 (OK)
- Practice address
- 1322 Klabzuba Ave
Prague, OK 74864-4900 - Phone
- (405) 567-4922
- NPI assigned
- Oct 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Oklahoma Ambulatory Services LLC
Practice addresses (Care Compare)
13722 N Bryant Ave
Suite 200
Edmond, OK 73013-6464
Phone (405) 295-5965
1380 W Covell Rd
132 Mercy Gohealth Urgent Care N Edmond
Edmond, OK 73003-3575
Phone (405) 279-9637
228 S Bryant Ave
Suite 8
Edmond, OK 73034-5723
Phone (405) 938-1389
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210504002100 | OK | Practitioner - Physician Assistant | 3678982618 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3213 | OK | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3213 | OK | Yes |
Addresses
Primary practice location
1322 Klabzuba Ave
Prague, OK 74864-4900
Mailing address
1322 Klabzuba Ave
Prague, OK 74864-4900
Phone (405) 567-4922
Other practice location 1
2301 NW 120th St
Oklahoma City, OK 73120-7409
Phone (405) 315-7815
Other names
- Elizabeth Oakley Peters
Other providers in Prague, OK
- Sharon Emmons
- Amanda Fipps
- Melinda May Fisher
- Carmen Floris
- Foundations Therapy, PLLC
- Harps Food Stores, Inc
- Belinda Ranee Harris
- Yvonne Hayes
- Joseph Wesley Holman
- Jay L Hutchens
All providers in Prague, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.