Individual provider Active NPI

Rand Salous, PA-C

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1902669229
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
16508 Village Garden Dr
Edmond, OK 73012-7078
Phone
(405) 365-8736
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 OK Primary

Addresses

Primary practice location

16508 Village Garden Dr
Edmond, OK 73012-7078

Mailing address

16508 Village Garden Dr
Edmond, OK 73012-7078
Phone (405) 365-8736

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
I20240509003415 OK Practitioner - Physician Assistant 6901247857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Health Allset Urgent Care LLCGroup PAC ID 3173972627, 54 clinicians

Practice addresses (Care Compare)

2249 W Danforth Rd
Edmond, OK 73003-4600
Phone (405) 427-4954

3075 Classen Blvd
Norman, OK 73071-4005
Phone (405) 552-0155

3224 S Broadway
Suite 112
Edmond, OK 73013-4069
Phone (405) 427-4945

5401 N Penn Ave
Oklahoma City, OK 73112-7751
Phone (405) 427-4944

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rsalous415820@direct.integrisok.com

Organizations & group practices 1

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1902669229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16508 VILLAGE GARDEN DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127078",
            "telephone_number": "405-365-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16508 VILLAGE GARDEN DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127078",
            "telephone_number": "405-365-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOUS",
        "first_name": "RAND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.