Individual provider Active NPI

Anllely Justo, CRNA

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1942877469
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
208730 Issued in OK
Practice address
920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036
Phone
(405) 271-4351
Fax
(405) 271-8695
NPI assigned
Jun 4, 2021
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 226031 SC
Anesthesiology Physician 207L00000X 208730 OK Primary

Addresses

Primary practice location

920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036

Mailing address

920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036
Phone (405) 271-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221012003620 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789050980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Puerto Rico School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
226031SCMDRegistered Nurse
208730OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomed Staffing LLC Anesthesiology CurrentSince Sep 1, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Aug 4, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Aug 4, 2022 Accepting new patients

Locations

11200 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 936-1000

5925 NW 139th St
Oklahoma City, OK 73142
Phone (405) 621-8800

8100 S Walker Ave
Bldg C
Oklahoma City, OK 73139
Phone (405) 602-6500

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

920 Stanton L Young Blvd
Oklahoma City, OK 73104
Phone (405) 271-5251

920 Stanton L Young Blvd
Ste 1140
Oklahoma City, OK 73104

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

Hospital & facility affiliations 1

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1942877469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTO",
        "first_name": "ANLLELY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "226031",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "208730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.