Individual provider Active NPI

Ellen Hoelscher, PA-C

  • Physician Assistant
  • Pryor, OK
National Provider Identifier
1730625625
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2633 Issued in OK
Practice address
4115 Redden
Pryor, OK 74361-9192
Phone
(918) 825-7555
NPI assigned
Jan 16, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 2633 OK Primary

Addresses

Primary practice location

4115 Redden
Pryor, OK 74361-9192

Mailing address

4115 Redden
Pryor, OK 74361-9192

Other practice location 1

1587 E 59th St
Tulsa, OK 74105-8005
Phone (405) 760-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170322001184 OK Practitioner - Physician Assistant 4082999669 Reassigns benefits to 1 organization
I20201013003085 CO Practitioner - Physician Assistant 4082999669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

3207 N Academy Blvd
Colorado Springs, CO 80917-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2633OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Oct 5, 2020 Accepting new patients
Peak Vista Community Health Centers CurrentSince Oct 5, 2020 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 100
Colorado Springs, CO 80917
Phone (719) 776-3600

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Interoperability endpoints

  • Direct secure messaging: ellen.hoelscher.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 4

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": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730625625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 REDDEN",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743619192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 REDDEN",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743619192",
            "telephone_number": "918-825-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1587 E 59th St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741058005",
            "country_code": "US",
            "telephone_number": "405-760-0303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOELSCHER",
        "first_name": "ELLEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.