NPIMap

Individual provider Active NPI

Ryne Shafer, PA-C, D.C.

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1639468648
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3225 Issued in OK
Practice address
13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone
(800) 781-1220
NPI assigned
Mar 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 4145 OK
Physician Assistant 363A00000X 3225 OK Primary

Addresses

Primary practice location

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431

Mailing address

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone (800) 781-1220

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
I20200821000899 OK Practitioner - Physician Assistant 4183040082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

9800 Broadway Ext
Oklahoma City, OK 73114-6304

9800 Broadway Extension
Suite 203
Oklahoma City, OK 73114-6304
Phone (405) 427-6776

Hospital & facility affiliations

  • Community Hospital, LLC Hospital, Oklahoma City, OK, CCN 370203
  • Integris Health Woodward Hospital Hospital, Woodward, OK, CCN 370002
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mercy Hospital Ada Hospital, Ada, OK, CCN 370020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4145OKMDMental Health Counselor
3225OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Community Hospital LLC Past Accepting new patients

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 6

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": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1639468648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "800-781-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "800-781-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "RYNE",
        "name_prefix": "Dr.",
        "credential": "PA-C, D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OK",
            "license": "4145",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.