Individual provider Active NPI

Yolanda Maria Prassada, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1811008337
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1762 Issued in OK
Practice address
4833 Integris Pkwy Ste 200
Edmond, OK 73034-8864
Phone
(405) 657-3825
Fax
(405) 657-3824
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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 1762 OK Primary

Addresses

Primary practice location

4833 Integris Pkwy Ste 200
Edmond, OK 73034-8864

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (405) 657-3825

Other identifiers 1

IdentifierTypeStateIssuer
200247620AMedicaidOK

Other names 1

  • Yolanda Maria Espejo Former name

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
I20100811000947 OK Practitioner - Physician Assistant 5890829931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 657-3150

4833 Integris Pkwy
Edmond, OK 73034-8864

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1091NEMDAddiction (Substance Use Disorder) Counselor
001503IAMDMental Health Counselor
1762OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Integris Health Edmond, Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yprassada193198@direct.integrisok.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 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1811008337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-657-3825",
            "fax_number": "405-657-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 INTEGRIS PKWY STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348864",
            "telephone_number": "405-657-3825",
            "fax_number": "405-657-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASSADA",
        "first_name": "YOLANDA",
        "middle_name": "MARIA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200247620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YOLANDA",
            "last_name": "ESPEJO",
            "middle_name": "MARIA",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.