Meredith L. Mogan, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1884 Issued in OK

Practice address

1713B S Peoria Ave
Tulsa, OK 74120-6801

Phone

(918) 622-2500

Fax

(405) 789-6734

NPI assigned

Mar 15, 2010

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Men'S Health, Inc.Group PAC ID 7113235086, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Center for Men'S Health, Inc.

  • Adult Medicine Physician
  • Broken Arrow, OK
  • NPI 1336552710
  Medicare reassignment Care Compare group
• The Physicians Group LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1487620381
  Medicare reassignment
• Lana G Nelson DO PC

  • Surgery Physician
  • Moore, OK
  • NPI 1306933726
  NPD (past)

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1598089955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713B S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741206801",
            "telephone_number": "918-622-2500",
            "fax_number": "405-419-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713B S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741206801",
            "telephone_number": "918-622-2500",
            "fax_number": "405-789-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGAN",
        "first_name": "MEREDITH",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modify, PLLC
• Kristen Dawn Moeller
• Roxann Renee Moeller, LCSW
• Sareesa Moeller
• Jerry Moffatt
• Lisa S Mogelnicki, DPM
• Krishnakanth Rithvik Mogili
• Saron Mogos
• Maria Cristina Moguel
• Deborah Zayneb Mohamad Ali, M.D.

• Family Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.