NPIMap

Individual provider Active NPI

Kacie Cassaday, D.O.

  • Family Medicine Physician
  • Shawnee, OK
National Provider Identifier
1669790598
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5720 Issued in OK
Practice address
4651 N Harrison St
Shawnee, OK 74804-1440
Phone
(405) 214-1500
Fax
(405) 214-1507
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5720 OK Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 5720 OK

Addresses

Primary practice location

4651 N Harrison St
Shawnee, OK 74804-1440

Mailing address

4651 N Harrison St
Shawnee, OK 74804-1440
Phone (405) 214-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151008001115 OK Practitioner - Sports MedicinePractitioner - Family Practice 4284942475 Reassigns benefits to 1 organization
I20190314001016 WA Practitioner - Family Practice 4284942475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

2749 Progressive Dr
Edmond, OK 73034-7649
Phone (405) 772-4130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5720OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
Saints Medical Group, LLC Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 12, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 12, 2018 Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients

Locations

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

4651 N Harrison St
Shawnee, OK 74804
Phone (405) 214-5100

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: kcassaday310696@direct-ehr-ssmhc.com

Organizations & group practices 5

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 7

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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1669790598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 N HARRISON ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041440",
            "telephone_number": "405-214-1500",
            "fax_number": "405-214-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 N HARRISON ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041440",
            "telephone_number": "405-214-1500",
            "fax_number": "405-214-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSADAY",
        "first_name": "KACIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5720",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OK",
            "license": "5720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.