Individual provider Active NPI

Cassandra Lynn Clay, DO

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1841711504
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS17935 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-6404
Phone
(352) 265-5911
NPI assigned
Jul 3, 2017
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0183R OK
Emergency Medicine Physician 207P00000X OS17935 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-6404

Mailing address

PO Box 100186
Gainesville, FL 32610-0186
Phone (352) 265-5911

Other practice location 1

901 N Porter Ave
Norman, OK 73071-6404
Phone (405) 307-1000

Other identifiers 1

IdentifierTypeStateIssuer
110904800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190502002214 OK Practitioner - Emergency Medicine 6800138397 Reassigns benefits to 6 organizations
I20230824002838 TX Practitioner - Emergency Medicine 6800138397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS17935FLMDEmergency Medicine Physician
0183ROKMDEmergency Medicine Physician
6381OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Jun 7, 2022 Accepting new patients
Cherokee Nation CurrentSince Aug 20, 2023 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Mercy Hospital Kingfisher, Inc Current Accepting new patients
Mercy Hospital Kingfisher, Inc CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital Logan County Inc CurrentSince Jul 1, 2019 Accepting new patients
Cherokee Nation CurrentSince Aug 20, 2023 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jul 1, 2019 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1841711504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100186",
            "telephone_number": "352-265-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326106404",
            "telephone_number": "352-265-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 N Porter Ave",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730716404",
            "country_code": "US",
            "telephone_number": "405-307-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAY",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2021-07-15",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "0183R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS17935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110904800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.