Individual provider Active NPI

Patricia Elena Sifuentes, LMT, MLD-C

  • Massage Therapist
  • Oklahoma City, OK
National Provider Identifier
1679930283
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT109063 Issued in TX
Practice address
14901 N Pennsylvania Ave
Oklahoma City, OK 73134-6069
Phone
(918) 385-1177
NPI assigned
Jan 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT109063 TX Primary
Kinesiotherapist 226300000X

Addresses

Primary practice location

14901 N Pennsylvania Ave
Oklahoma City, OK 73134-6069

Mailing address

10105 Carnie Cir
Yukon, OK 73099-8309
Phone (918) 385-1177

Other identifiers 2

IdentifierTypeStateIssuer
810815010OtherOKLICENSED MASSAGE THERAPIST
MT109063OtherTXLISENCED MASSAGE THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT109063TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1679930283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 CARNIE CIR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998309",
            "telephone_number": "918-385-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 N PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346069",
            "telephone_number": "918-385-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFUENTES",
        "first_name": "PATRICIA",
        "middle_name": "ELENA",
        "credential": "LMT, MLD-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2022-02-21",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT109063",
            "primary": true
        },
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASSAGE THERAPIST",
            "identifier": "810815010",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISENCED MASSAGE THERAPIST",
            "identifier": "MT109063",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.