Individual provider Active NPI

Kelly Elizabeth Meszaros

  • Social Worker
  • Stillwater, OK
National Provider Identifier
1942798087
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
604 S Walnut St
Stillwater, OK 74074-4222
Phone
(918) 418-3045
NPI assigned
Apr 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X Primary

Addresses

Primary practice location

604 S Walnut St
Stillwater, OK 74074-4222

Mailing address

604 S Walnut St
Stillwater, OK 74074-4222
Phone (918) 418-3045

Other identifiers 1

IdentifierTypeStateIssuer
43-1236557MedicaidOK

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210226002052 OK Practitioner - Clinical Social Worker 6901211861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

604 S Walnut St
Stillwater, OK 74074-4222
Phone (405) 372-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7709OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center Inc CurrentSince Feb 11, 2021 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Feb 11, 2021 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

604 S Walnut St
Stillwater, OK 74074
Phone (405) 338-7072

Organizations & group practices 3

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1942798087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "918-418-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "918-418-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESZAROS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43-1236557",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.