Justin B Plaxico, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

3875 Issued in OK

Practice address

435 N Monte Vista St
Ada, OK 74820-4676

Phone

(580) 310-0102

Fax

(580) 310-0104

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Oklahoma State University College of Osteopathic Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jplaxico1297756@directc.mercy.net

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment Care Compare group NPD
• Choctaw County City of Hugo Hospital Authority

  • Rural Acute Care Hospital
  • Hugo, OK
  • NPI 1881689289
  Medicare reassignment NPD
• Mercy Hospital Ada, Inc

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  NPD (past)
• Mercy Hospital Oklahoma City, Inc

  • Diagnostic Radiology Physician
  • Yukon, OK
  • NPI 1730326406

  Surgery

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1518996958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204676",
            "telephone_number": "580-310-0102",
            "fax_number": "580-310-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204676",
            "telephone_number": "580-310-0102",
            "fax_number": "580-310-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAXICO",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "3875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Picazo
• David M Pierce, MD
• Nancy Pierce, LPC
• Kylia Pinson
• Victoria Leigh Pipestem
• Michelle L Plummer, COTA/L
• Jessica Janae Plunk, PA-C
• Christopher Michael Poarch, NP
• Erica Rayann Poe Valles, MD
• Marcus Pogue, MA

• Surgery Physician in Ada, OK
• Providers in Ada, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.