Zackery R Devine, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4394 Issued in OK

Practice address

2017 W I 35 Frontage Rd Ste 140
Edmond, OK 73013-8555

Phone

(405) 757-3710

Fax

(405) 757-3711

NPI assigned

Nov 3, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hillcrest Urgent Care, LLCGroup PAC ID 6608393715, 41 clinicians

Tulsa Emergency Medical Center IncGroup PAC ID 3375442692, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: zdevine1072673@directc.mercy.net
• Direct secure messaging: zackery.devinepac.p10@direct.nextcare.nextgenshare.com
• Direct secure messaging: zackery.devine.p11@direct.okc.nextgenshare.com
• Direct secure messaging: zackery.devinepac.p8@direct.nextcare.nextgenshare.com

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.

• Hillcrest Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1417769829
  Medicare reassignment Care Compare group
• Tulsa Emergency Medical Center Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1063479087
  Medicare reassignment Care Compare group
• Medical Resource Management, LLC

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1104056365
  Medicare reassignment
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Optimum Family Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1871263459
  Medicare reassignment
• Optimum Primary Care PLLC

  • Internal Medicine Physician
  • Edmond, OK
  • NPI 1760030399
  Medicare reassignment
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1700487147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD STE 140",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138555",
            "telephone_number": "405-757-3710",
            "fax_number": "405-757-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD STE 140",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138555",
            "telephone_number": "405-757-3710",
            "fax_number": "405-757-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "ZACKERY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Savannah Detert
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• April Lynn Devereaux, FNP-C
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• Stephen J Devries
• Lamar Dewberry
• DHC Faith Holdings, LLC
• Diagnostic Laboratory of Oklahoma, LLC

• Physician Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.