Individual provider Active NPI

Lauren Bubb, PA-C

  • Physician Assistant
  • Ada, OK
National Provider Identifier
1609652429
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1207826 Issued in OK
Practice address
3101 Arlington St
Ada, OK 74820-3085
Phone
(580) 332-9100
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 1207826 OK Primary

Addresses

Primary practice location

3101 Arlington St
Ada, OK 74820-3085

Mailing address

4608 Jay Matt Dr
Yukon, OK 73099-2305
Phone (405) 326-7535

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231129002590 OK Practitioner - Physician Assistant 2163870205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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)

1201 Health Ctr Pkwy
Yukon, OK 73099-6381
Phone (405) 717-6800

1608 Professional Cir
Yukon, OK 73099-6314
Phone (405) 494-9300

1651 Professional Cir
Yukon, OK 73099-6314
Phone (405) 350-6770

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 657-3150

4833 Integris Pkwy
Edmond, OK 73034-8864

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5018OKMDProfessional Counselor
1207826OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Oklahoma City, Inc PastSince Sep 10, 2023 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lbubb287819@direct.integrisok.com

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 and National Provider Directory roles.

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1609652429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 JAY MATT DR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730992305",
            "telephone_number": "405-326-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203085",
            "telephone_number": "580-332-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBB",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1207826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.