Individual provider Active NPI

Alexandra Lich, MD

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1932460623
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29199 Issued in OK
Practice address
940 NE 13TH St
Oklahoma City, OK 73104-5008
Phone
(405) 271-4417
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29199 OK Primary

Addresses

Primary practice location

940 NE 13TH St
Oklahoma City, OK 73104-5008

Mailing address

940 NE 13TH St
Oklahoma City, OK 73104-5008
Phone (405) 271-4417

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180201002199 OK Practitioner - Pediatric Medicine 2860752318 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 1, 2018 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 1, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

937 SW 89th St
Ste A
Oklahoma City, OK 73139
Phone (405) 271-7447

940 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-2429

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

34 SW 89th St
Oklahoma City, OK 73139
Phone (405) 488-0750

Interoperability endpoints

  • Direct secure messaging: alich25654@ouhealth.direct-ci.net

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1932460623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICH",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "29199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.