Elizabeth Oakley Haak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3213 Issued in OK

Practice address

1322 Klabzuba Ave
Prague, OK 74864-4900

Phone

(405) 567-4922

NPI assigned

Oct 12, 2020

Last updated

Oct 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Oakley Peters Former name

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mercy Oklahoma Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1922509173
  Medicare reassignment Care Compare group
• Prague Healthcare Authority

  dba Prague Memorial Regional Hospital

  • Emergency Medicine Physician
  • Prague, OK
  • NPI 1851537096
  Medicare reassignment
• Prague Healthcare Authority

  dba Prague Memorial Regional Hospital

  • Critical Access Hospital
  • Prague, OK
  • NPI 1750527768
  NPD

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1508464686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 KLABZUBA AVE",
            "city": "PRAGUE",
            "state": "OK",
            "postal_code": "748644900",
            "telephone_number": "405-567-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 KLABZUBA AVE",
            "city": "PRAGUE",
            "state": "OK",
            "postal_code": "748644900",
            "telephone_number": "405-567-4922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 NW 120th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731207409",
            "country_code": "US",
            "telephone_number": "405-315-7815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAK",
        "first_name": "ELIZABETH",
        "middle_name": "OAKLEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PETERS",
            "middle_name": "OAKLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon Emmons, M.ED
• Amanda Fipps, LPN
• Melinda May Fisher, DPH
• Carmen Floris, LPC
• Foundations Therapy, PLLC (Foundations Therapy Prague)
• Harps Food Stores, Inc (Harps Pharmacy #477)
• Belinda Ranee Harris, LPC
• Yvonne Hayes
• Joseph Wesley Holman, D.C.
• Jay L Hutchens, DDS

• Physician Assistant in Prague, OK
• Providers in Prague, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.