Individual provider Active NPI

Ralph Falconer, PA-C

  • Physician Assistant
  • Tishomingo, OK
National Provider Identifier
1932130150
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
670 Issued in OK
Practice address
610 E 24TH St
Tishomingo, OK 73460-3245
Phone
(580) 371-2343
Fax
(580) 371-3614
NPI assigned
Jul 5, 2006
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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 670 OK Primary

Addresses

Primary practice location

610 E 24TH St
Tishomingo, OK 73460-3245

Mailing address

610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 371-2343

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
I20040427000311 OK Practitioner - Physician Assistant 5890782478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21 N Main St
Kingston, OK 73439-6562
Phone (580) 387-0509

610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 387-0509

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
670OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Southern Oklahoma Inc CurrentSince Feb 1, 2017 Accepting new patients
Texomacare Physician Assistant CurrentSince Feb 2, 2015 Accepting new patients
Family Health Center of Southern Oklahoma Inc CurrentSince Feb 1, 2017 Accepting new patients
Family Health Center of Southern Oklahoma Inc Past Accepting new patients
Neon Clinic Inc Past Accepting new patients

Locations

610 E 24th St
Tishomingo, OK 73460
Phone (580) 371-2343

5012 US Highway 75
Ste 300
Denison, TX 75020
Phone (903) 416-6025

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73380
  • FHIR API: https://fhir4.healow.com/fhir/r4/CDGFAA
  • Direct secure messaging: ralph.falconer@fhcso.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1932130150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCONER",
        "first_name": "RALPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, OK

Sources for this page

Verify at the official NPI Registry.