Individual provider Active NPI

Samantha Dawn Stretesky, RD/LD, PA-C

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1720474703
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4449 Issued in OK
Practice address
1 S Bryant Ave
Edmond, OK 73034-6309
Phone
(405) 271-2663
NPI assigned
Apr 7, 2015
Last updated
Apr 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4449 OK Primary
Registered Dietitian 133V00000X 2041 OK

Addresses

Primary practice location

1 S Bryant Ave
Edmond, OK 73034-6309

Mailing address

1 S Bryant Ave
Edmond, OK 73034-6309
Phone (405) 271-2663

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
I20201125000452 OK Practitioner - Physician Assistant 9830500719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2041OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Feb 2, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1 S Bryant Ave
Edmond, OK 73034
Phone (405) 341-6100

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

825 NE 10th St
Ste 1C
Oklahoma City, OK 73104
Phone (405) 271-2663

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1720474703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346309",
            "telephone_number": "405-271-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346309",
            "telephone_number": "405-271-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRETESKY",
        "first_name": "SAMANTHA",
        "middle_name": "DAWN",
        "credential": "RD/LD, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4449",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.