Individual provider Active NPI

Michelle Renee Lapidus, P.A.-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1962508457
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2561 Issued in OK
Practice address
13301 N Meridian Ave Ste 201
Oklahoma City, OK 73120-8381
Phone
(405) 803-8020
Fax
(405) 437-2332
NPI assigned
Sep 15, 2006
Last updated
Dec 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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 2561 OK Primary

Addresses

Primary practice location

13301 N Meridian Ave Ste 201
Oklahoma City, OK 73120-8381

Mailing address

PO Box 54333
Oklahoma City, OK 73154-1333
Phone (405) 803-8020

Other practice location 1

4101 NW 122nd St
Oklahoma City, OK 73120-8800
Phone (405) 803-8020

Other identifiers 1

IdentifierTypeStateIssuer
200613850AMedicaidOK

Other names 1

  • Michelle Renee Ouellette Former name

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
I20151116000890 OK Practitioner - Physician Assistant 6305886300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randr Dermatology Services PLLCGroup PAC ID 1658798103, 8 clinicians

Practice addresses (Care Compare)

13301 N Meridian Ave
Oklahoma City, OK 73120-8381
Phone (405) 803-8020

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Dermatology PLLC CurrentSince Jul 1, 2020 Accepting new patients
Southside Dermatology PLLC PastSince Jun 22, 2021 Accepting new patients

Locations

6966 S Utica Ave
Ste 225
Tulsa, OK 74136
Phone (855) 492-6333

Interoperability endpoints

  • Direct secure messaging: mlapidus@oklahomaderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1962508457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54333",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731541333",
            "telephone_number": "405-803-8020",
            "fax_number": "405-437-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 N MERIDIAN AVE STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208381",
            "telephone_number": "405-803-8020",
            "fax_number": "405-437-2332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 NW 122nd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731208800",
            "country_code": "US",
            "telephone_number": "405-803-8020",
            "fax_number": "405-437-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAPIDUS",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200613850A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "OUELLETTE",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.