NPIMap

Individual provider Active NPI

Justin Homer, PA

  • Medical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1558519546
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2158 Issued in OK
Practice address
1000 N Lee Ave
4TH Floor
Oklahoma City, OK 73102-1036
Phone
(405) 272-7699
Fax
(405) 272-6662
NPI assigned
Sep 3, 2008
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2158 OK Primary

Addresses

Primary practice location

1000 N Lee Ave
4TH Floor
Oklahoma City, OK 73102-1036

Mailing address

PO Box 269064
Oklahoma City, OK 73126-9064
Phone (405) 231-3857

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhomer68786@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20121017000872 OK Practitioner - Physician Assistant 1658422506 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7000

608 NW 9TH St
Oklahoma City, OK 73102-1049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2158OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Jul 2, 2018 Accepting new patients
SSM Health Care of Oklahoma, Inc. CurrentSince Oct 1, 2012 Accepting new patients
SSM Healthcare of Ok, Inc Past Accepting new patients
Saints Medical Group, LLC Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

1000 N Lee Ave
Fl 4
Oklahoma City, OK 73102
Phone (405) 272-7699

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

Interoperability endpoints

  • Direct secure messaging: jhomer68786@direct-ehr-ssmhc.com

Organizations & group practices 6

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 5

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1558519546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269064",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269064",
            "telephone_number": "405-231-3857",
            "fax_number": "405-272-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "address_2": "4TH FLOOR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-272-7699",
            "fax_number": "405-272-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhomer68786@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jhomer68786@direct-ehr-ssmhc.com",
            "address_1": "1000 N Lee Ave",
            "address_2": "4th Floor",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731021036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 N Lee Ave",
            "address_2": "4th Floor",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731021036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.