Active NPI
Lisa Renea Pate, APRN-CNP
- Family Nurse Practitioner
- Ada, OK
National Provider Identifier
1710528674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 104727
- Practice address
- 730 Finley Dr
Ada, OK 74820-5392 - Phone
- (580) 421-6470
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 104727 | OK | Primary |
Addresses
Primary practice location
730 Finley Dr
Ada, OK 74820-5392
Mailing address
730 Finley Dr
Ada, OK 74820-5392
Phone (580) 421-6470
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | LandrumENT.com |
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191204000214 | OK | Practitioner - Nurse Practitioner | 2163855271 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
730 Finley Dr
Ada, OK 74820-5392
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boogers R US PLLC | Current | Accepting new patients |
Locations
730 Finley Dr
Ada, OK 74820
Phone (580) 421-6470
415 W Guy Ave
Ofc
Pauls Valley, OK 73075
Phone (580) 421-6470
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Ada, OK
- NPI 1871864439
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ada, OK
- NPI 1952643306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1710528674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 FINLEY DR",
"city": "ADA",
"state": "OK",
"postal_code": "748205392",
"telephone_number": "580-421-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 FINLEY DR",
"city": "ADA",
"state": "OK",
"postal_code": "748205392",
"telephone_number": "580-421-6470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATE",
"first_name": "LISA",
"middle_name": "RENEA",
"name_prefix": "Mrs.",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "104727",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "LandrumENT.com",
"affiliation": "N",
"address_1": "730 Finley Dr",
"city": "Ada",
"state": "OK",
"country_code": "US",
"postal_code": "748205392",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.