Saura C Douglas, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2372 Issued in OK

Practice address

1145 S Utica Ave Ste 202
Tulsa, OK 74104-4022

Phone

(918) 579-3130

Fax

(918) 579-3139

NPI assigned

Jan 31, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Saura Shanaki Former name

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
• Direct secure messaging: sshanaki181208@ahs.direct-ci.com

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.

• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Physician Assistant

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Claremore Regional Hospital, LLC.

  • General Acute Care Hospital
  • Claremore, OK
  • NPI 1023398807
  Care Compare affiliation
• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Bailey Medical Center, LLC

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1205846037
  Care Compare affiliation

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1760805329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044022",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044022",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SAURA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2372",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2372",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "2372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200550180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAURA",
            "last_name": "SHANAKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Douglas R Banning, D.O.
• Alexander Douglas
• Gladys Renee Douglas
• Michael L Douglas
• Orlando D Douglas
• Lindsea Elizabeth Douillard
• April Douthit
• Andrew Boyd Douthitt, AG-ACNP-BC, FNP-BC
• Dove of Peace Hospice Care Corp.
• Dove Schools Inc

• Surgical Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Surgical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.