Taelor Baetz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5266 Issued in OK

Practice address

415 Fairview Ave Ste 201
Ponca City, OK 74601-1932

Phone

(580) 762-9355

Fax

(580) 762-9358

NPI assigned

May 15, 2023

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

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)

Hospital & facility affiliations

• Integris Health Ponca City Hospital, Ponca City, OK, CCN 370006
• Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049
• Stillwater Medical-Blackwell Hospital, Blackwell, OK, CCN 370780

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCFCCA
• Direct secure messaging: tbaetz490381@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  dba INTEGRIS Medical Group

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment Care Compare group
• Premier Pulmonary Critical Care and Sleep Medicine, PA

  • Pulmonary Disease Physician
  • Denison, TX
  • NPI 1740557909
  Medicare reassignment
• Dermatology Associates of Denison PLLC

  • Specialist
  • Denison, TX
  • NPI 1699111476
  NPD
• Integris Ambulatory Care C Orporation

  dba ProHealth Physicians

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)
• Integris Health Ponca City Hospital Inc

  dba Integris Health Ponca City Hospital

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Integris Health Ponca City Hospital Inc

  dba Integris Health Ponca City Hospital

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  Care Compare affiliation
• Stillwater Medical Center Authority

  dba Blackwell Regional Hospital

  • Rural Acute Care Hospital
  • Blackwell, OK
  • NPI 1104375237
  Care Compare affiliation
• Stillwater Medical Center Authority

  dba Stillwater Medical Center

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  Care Compare affiliation

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1881385656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "580-762-9355",
            "fax_number": "580-762-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 FAIRVIEW AVE STE 201",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011932",
            "telephone_number": "580-762-9355",
            "fax_number": "580-762-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAETZ",
        "first_name": "TAELOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Vincent Archer
• Amanda Arie
• Surat Attaphitaya, DMD
• Avenue of Hope Assoc.
• Rachael Ann Backus
• Mary E Bahruth-Poskey, M.S.,C.C.C.
• Lionel Everett Bair II, D.D.S.
• Elizabeth Bales
• Lindsey Renee Bales
• Shayla Barber

• Physician Assistant in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.