Individual provider Active NPI

Chanda T Kersey, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1730215708
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1520 Issued in OK
Practice address
5200 E I 240 Service Rd
Oklahoma Heart Hospital South Wound Care Center
Oklahoma City, OK 73135-2607
Phone
(405) 628-6405
Fax
(405) 753-1849
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1520 OK Primary

Addresses

Primary practice location

5200 E I 240 Service Rd
Oklahoma Heart Hospital South Wound Care Center
Oklahoma City, OK 73135-2607

Mailing address

PO Box 848371
Boston, MA 02284-8371
Phone (904) 446-3451

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
I20060306000144 OK Practitioner - Physician Assistant 2769498021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1000 NE 13TH St
Oklahoma City, OK 73104-5040
Phone (405) 271-3445

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

Hospital & facility affiliations

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
1520OKMDClinical Social Worker
PA1520OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 30, 2017 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 30, 2017 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Oklahoma Hma Urgent Care, LLC Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1122 NE 13th St
#274
Oklahoma City, OK 73117

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

1000 NE 13th St
Ste 1C
Oklahoma City, OK 73104
Phone (405) 271-5604

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

Organizations & group practices 7

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 1

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1730215708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848371",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848371",
            "telephone_number": "904-446-3451",
            "fax_number": "904-446-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 E I 240 SERVICE RD",
            "address_2": "OKLAHOMA HEART HOSPITAL SOUTH WOUND CARE CENTER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731352607",
            "telephone_number": "405-628-6405",
            "fax_number": "405-753-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "CHANDA",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA1520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.