NPIMap

Organization Active NPI

Plastic Surgery Associates PA

Doing business as Breast Reconstruction Associates

  • Plastic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1821568304
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY ASSOCIATES PA
Doing business as
Breast Reconstruction Associates
Practice address
8516 S. Portland Ste 201
Oklahoma City, OK 73159-5006
Phone
(405) 246-0391
Fax
(405) 246-0392
NPI assigned
Nov 28, 2018
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PLASTIC SURGERY ASSOCIATES PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Sylviana Crawford
Title
Office Administrator
Phone
(682) 200-8580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

8516 S. Portland Ste 201
Oklahoma City, OK 73159-5006

Mailing address

8601 Cantera Way
Benbrook, TX 76126-1133
Phone (512) 763-4545

Other names 1

  • Breast Reconstruction Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190305001609 OK Part B Supplier - Clinic/Group Practice 9032361126 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Plastic Surgery Associates

Locations

12201 Renfert Way
Ste 100
Austin, TX 78758
Phone (512) 454-0341

1250 8th Ave
Ste 575
Fort Worth, TX 76104
Phone (682) 200-8580

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1821568304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 CANTERA WAY",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761261133",
            "telephone_number": "512-763-4545",
            "fax_number": "512-763-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8516 S. PORTLAND STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731595006",
            "telephone_number": "405-246-0391",
            "fax_number": "405-246-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLASTIC SURGERY ASSOCIATES PA",
        "enumeration_date": "2018-11-28",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "SYLVIANA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "682-200-8580"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breast Reconstruction Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.