Individual provider Active NPI

Sierra Lynn Stouffer, PA-S

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1669013835
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11912 S Norwood Ave
Tulsa, OK 74137-5547
Phone
(918) 943-5303
Fax
(855) 312-3594
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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 Primary

Addresses

Primary practice location

11912 S Norwood Ave
Tulsa, OK 74137-5547

Mailing address

PO Box 200
Jenks, OK 74037-0200
Phone (918) 748-7585

Other practice location 1

13616 E 103rd St N Ste C
Owasso, OK 74055-4592
Phone (918) 943-5303

Other names 1

  • Sierra Lynn Gillette Former name

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
I20210428001851 OK Practitioner - Physician Assistant 9739597915 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4550OKMDDentist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1669013835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740370200",
            "telephone_number": "918-748-7585",
            "fax_number": "855-312-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 S NORWOOD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375547",
            "telephone_number": "918-943-5303",
            "fax_number": "855-312-3594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13616 E 103rd St N Ste C",
            "address_purpose": "LOCATION",
            "city": "Owasso",
            "state": "OK",
            "postal_code": "740554592",
            "country_code": "US",
            "telephone_number": "918-943-5303",
            "fax_number": "855-312-3594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUFFER",
        "first_name": "SIERRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIERRA",
            "last_name": "GILLETTE",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.