Individual provider Active NPI

Laurie Leigh Isenberg, PA

  • Medical Physician Assistant
  • Bixby, OK
National Provider Identifier
1710903604
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1342 Issued in OK
Practice address
7333 E 121St St S
Bixby, OK 74008
Phone
(918) 403-7140
Fax
(918) 856-5392
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1342 OK Primary

Addresses

Primary practice location

7333 E 121St St S
Bixby, OK 74008

Mailing address

7333 E 121St St S
Bixby, OK 74008-2654
Phone (918) 403-7140

Other practice location 1

5050 E Kenosha St
Broken Arrow, OK 74014-6711
Phone (918) 355-9492

Other practice location 2

5050 E Kenosha St
Broken Arrow, OK 74014-6711
Phone (918) 355-9492

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001540 OK Practitioner - Physician Assistant 1557346822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2967

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1342OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 11, 2015 Accepting new patients
St. John Physicians, Inc. Past Accepting new patients

Locations

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Interoperability endpoints

  • Direct secure messaging: laurie.isenberg@direct.stjohnhealthsystem.com

Organizations & group practices 3

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 4

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1710903604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7333 E 121ST ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082654",
            "telephone_number": "918-403-7140",
            "fax_number": "918-856-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 E 121ST ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "74008",
            "telephone_number": "918-403-7140",
            "fax_number": "918-856-5392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 E Kenosha St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740146711",
            "country_code": "US",
            "telephone_number": "918-355-9492",
            "fax_number": "918-355-9250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 E Kenosha St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740146711",
            "country_code": "US",
            "telephone_number": "918-355-9492",
            "fax_number": "918-355-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISENBERG",
        "first_name": "LAURIE",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bixby, OK

Sources for this page

Verify at the official NPI Registry.