Individual provider Active NPI

Amy Yvonne Pasque, PA-C

  • Physician Assistant
  • Moore, OK
National Provider Identifier
1861119620
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4855 Issued in OK
Practice address
2900 S Telephone Rd
Moore, OK 73160-2968
Phone
(405) 237-7500
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 4855 OK Primary

Addresses

Primary practice location

2900 S Telephone Rd
Moore, OK 73160-2968

Mailing address

2512 O J Talley Cir
Norman, OK 73072-6619
Phone (405) 620-0642

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
I20230207002528 OK Practitioner - Physician Assistant 4183096845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4855OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery Medical Diagnostic Group, LLC CurrentSince Oct 30, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Jan 13, 2024 Accepting new patients

Locations

2900 S Telephone Rd
Moore, OK 73160
Phone (405) 225-0470

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1861119620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 O J TALLEY CIR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730726619",
            "telephone_number": "405-620-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968",
            "telephone_number": "405-237-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUE",
        "first_name": "AMY",
        "middle_name": "YVONNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.