Individual provider Active NPI

Timothy Joseph Stein, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1619486669
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2846 Issued in OK
Practice address
3366 NW Expressway Ste 800
Oklahoma City, OK 73112-4458
Phone
(405) 713-9935
Fax
(405) 713-9936
NPI assigned
Sep 21, 2017
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 2846 OK Primary

Addresses

Primary practice location

3366 NW Expressway Ste 800
Oklahoma City, OK 73112-4458

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 713-9935

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
I20180222000207 OK Practitioner - Physician Assistant 8820359417 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2846OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Healdton, Inc CurrentSince Sep 1, 2025 Accepting new patients
Mercy Hospital Healdton, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3462 Hospital Rd
Healdton, OK 73438
Phone (580) 229-0701

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1619486669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-713-9935",
            "fax_number": "405-713-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY STE 800",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124458",
            "telephone_number": "405-713-9935",
            "fax_number": "405-713-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.