NPIMap

Individual provider Active NPI

Kevin Charles Mason, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1558335539
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1062 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 230-9490
Fax
(405) 230-9421
NPI assigned
Feb 15, 2006
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 1062 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 230-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000510 OK Practitioner - Physician Assistant 1951383520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3700 36TH Ave NW
McBride Orthopedic Hospital Clinic Norman
Norman, OK 73072-1803
Phone (405) 230-9600

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1062OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Southwest Orthopaedic Specialists, P.L.L.C. Past Accepting new patients
McBride Clinic Orthopedic Hospital, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kevin.mason@moh.eclinicaldirectplus.com
  • Direct secure messaging: kevinmason@oklahomace.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1558335539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9490",
            "fax_number": "405-230-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9490",
            "fax_number": "405-230-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "KEVIN",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.