Individual provider Active NPI

Alexis Nicole Smirlis, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1679199673
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40910 Issued in OK
Practice address
1208 W 15TH St
Edmond, OK 73013-3001
Phone
(405) 340-2100
Fax
(405) 340-1184
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40910 OK Primary

Addresses

Primary practice location

1208 W 15TH St
Edmond, OK 73013-3001

Mailing address

1208 W 15TH St
Edmond, OK 73013-3001
Phone (405) 340-2100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122001559 OK Practitioner - Family Practice 3678996360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1208 W 15TH St
Edmond, OK 73013-3001
Phone (405) 340-2100

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Family Medicine CurrentSince Dec 1, 2023 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

1208 W 15th St
Edmond, OK 73013
Phone (405) 340-2100

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Organizations & group practices 2

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 2

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": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1679199673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133001",
            "telephone_number": "405-340-2100",
            "fax_number": "405-340-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133001",
            "telephone_number": "405-340-2100",
            "fax_number": "405-340-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRLIS",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "40910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.