Active NPI
Adrienne Allison Martin-Deangelis, PA
- Physician Assistant
- Oklahoma City, OK
National Provider Identifier
1740515295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 721
- Practice address
- 4140 W Memorial Rd
Ste 618
Oklahoma City, OK 73120-8366 - Phone
- (405) 751-1530
- NPI assigned
- Oct 15, 2009
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 721 | OK | Primary |
Addresses
Primary practice location
4140 W Memorial Rd
Ste 618
Oklahoma City, OK 73120-8366
Mailing address
3435 NW 56TH St
Ste 404
Oklahoma City, OK 73112-4414
Phone (405) 751-1530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 721 | OK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Network Inc | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1427097435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507248000000",
"number": "1740515295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3435 NW 56TH ST",
"address_2": "STE 404",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731124414",
"telephone_number": "405-751-1530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 W MEMORIAL RD",
"address_2": "STE 618",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731208366",
"telephone_number": "405-751-1530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN-DEANGELIS",
"first_name": "ADRIENNE",
"middle_name": "ALLISON",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-15",
"last_updated": "2017-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.