Tatiana Valerievna Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5225 Issued in OK

Practice address

3300 NW Expressway
Oklahoma City, OK 73112-4418

Phone

(405) 945-5215

Fax

(405) 713-2794

NPI assigned

Feb 12, 2024

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

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: twilson420690@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment Care Compare group

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

• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1548024359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 TERRACE RDG",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730260757",
            "telephone_number": "405-410-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-945-5215",
            "fax_number": "405-713-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TATIANA",
        "middle_name": "VALERIEVNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Lyon Wilson, M.D.
• Scott Wilson, BC-HIS
• Shelby Paige Wilson, SLPA
• Shelby Victoria Wilson
• Stephanie Dawn Wilson, PT
• Terri G. Wilson, CNP
• Trez Wilson
• Victoria Wilson
• Wendy Dee Wilson, RDN, LD, IBCLC
• William Wilson, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2024; 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.