NPIMap

Individual provider Active NPI

Lauren Wallace, PA-C

  • Physician Assistant
  • McAlester, OK
National Provider Identifier
1932851441
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4427 Issued in OK
Practice address
1 E Clark Bass Blvd Ste 201
McAlester, OK 74501-4209
Phone
(918) 421-6753
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 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 4427 OK Primary

Addresses

Primary practice location

1 E Clark Bass Blvd Ste 201
McAlester, OK 74501-4209

Mailing address

12624 SE 69TH St
Oklahoma City, OK 73150-7438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230111001861 OK Practitioner - Physician Assistant 1759751555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7000

1110 N Lee Ave
Oklahoma City, OK 73103-2612

3200 Medical Park Dr
Shawnee, OK 74804-5014
Phone (405) 878-3460

608 NW 9TH St
Oklahoma City, OK 73102-1049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4427OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McAlester Regional Health Center Authority Current Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 28, 2024 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 28, 2024 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

1 E Clark Bass Blvd
Ste 201
McAlester, OK 74501
Phone (918) 421-6753

201 S Sara Rd
Ste 200
Mustang, OK 73064
Phone (405) 578-3250

1110 N Lee Ave
Ste 200
Oklahoma City, OK 73103
Phone (405) 218-2530

3400 S Douglas Blvd
Ste 302
Oklahoma City, OK 73150
Phone (405) 272-2850

13500 S Tulsa Dr
Ste 301
Oklahoma City, OK 73170
Phone (405) 793-2900

13401 N Western Ave
Ste 301
Oklahoma City, OK 73114
Phone (405) 218-2530

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Interoperability endpoints

  • Direct secure messaging: lauren.wallace@direct.mrhcok.com
  • Direct secure messaging: lwallace382770@direct-ehr-ssmhc.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 and National Provider Directory roles.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1932851441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12624 SE 69TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731507438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CLARK BASS BLVD STE 201",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014209",
            "telephone_number": "918-421-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.