NPIMap

Individual provider Active NPI

Lisa S Mogelnicki, DPM

  • Podiatrist
  • Tulsa, OK
National Provider Identifier
1689967739
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
291 Issued in OK
Practice address
2431 E 61St St Ste 500
Tulsa, OK 74136-1208
Phone
(918) 582-6800
Fax
(918) 582-6060
NPI assigned
May 24, 2011
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 291 OK Primary

Addresses

Primary practice location

2431 E 61St St Ste 500
Tulsa, OK 74136-1208

Mailing address

2431 E 61St St Ste 500
Tulsa, OK 74136-1208
Phone (918) 582-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20110830000250 OK Practitioner - Podiatry 6901076959 Reassigns benefits to 2 organizations
I20231009003145 TX Practitioner - Podiatry 6901076959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pawnee Indian Health CenterGroup PAC ID 2769470160, 88 clinicians
Orthopaedic Center PCGroup PAC ID 8123915626, 19 clinicians
Osumc Professional Services LLCGroup PAC ID 9234254012, 21 clinicians

Practice addresses (Care Compare)

1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-2517

2431 E 61St St
Suite 500
Tulsa, OK 74136-1208
Phone (918) 582-6800

744 W 9TH St
Ok State Univ Med CNTR
Tulsa, OK 74127-9020

9645 Riverside Pkwy
Suite C
Tulsa, OK 74137-7427
Phone (918) 209-5170

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.37 of 100Reported as individual
Quality
79.02
Promoting interoperability
89
Improvement activities
20

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue255
Removal of skin lesions14
Removal of nail tissue214
Removal or shaving of skin growth134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
291OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pawnee Indian Health Center CurrentSince Feb 25, 2024 Accepting new patients
Orthopaedic Center, PC CurrentSince Mar 15, 2019 Accepting new patients
Orthopaedic Center, PC CurrentSince Mar 15, 2019 Accepting new patients
Osumc Professional Services LLC CurrentSince Dec 18, 2024 Accepting new patients
Pawnee IHS Pharmacy PastSince Sep 21, 2025 Accepting new patients
Oklahoma State University Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients
Oklahoma State University Medical Trust Past Accepting new patients

Locations

1201 Heritage Cir
Pawnee, OK 74058
Phone (918) 762-2517

2431 E 61st St
Ste 500
Tulsa, OK 74136
Phone (918) 925-3243

9645 Riverside Pkwy
Ste C
Tulsa, OK 74137
Phone (918) 209-5170

Dept 2732
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: lmogelnicki258463@ahs.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1689967739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 E 61ST ST STE 500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361208",
            "telephone_number": "918-582-6800",
            "fax_number": "918-582-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 E 61ST ST STE 500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361208",
            "telephone_number": "918-582-6800",
            "fax_number": "918-582-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGELNICKI",
        "first_name": "LISA",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.