Organization Active NPI

Sebastian PC

  • Psychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1982856548
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20879 Issued in OK
Legal business name
SEBASTIAN PC
Practice address
4100 W Memorial
Suite 221
Oklahoma City, OK 73120
Phone
(405) 755-5801
Fax
(405) 755-5949
NPI assigned
Oct 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Veronique Sebastian, MDNPI 1740371129
Title
President
Phone
(405) 755-5801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 20879 OK Primary

Addresses

Primary practice location

4100 W Memorial
Suite 221
Oklahoma City, OK 73120

Mailing address

12800 Castlerock CT
Oklahoma City, OK 73142-5127
Phone (405) 751-2605

Other identifiers 1

IdentifierTypeStateIssuer
800522305OtherOKPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090518000186 OK Part B Supplier - Clinic/Group Practice 9436208790 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

13321 N Meridian Ave
Ste 104
Oklahoma City, OK 73120
Phone (405) 755-5801

4140 W Memorial Rd
Ste 221
Oklahoma City, OK 73120
Phone (405) 755-5801

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1982856548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 CASTLEROCK CT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731425127",
            "telephone_number": "405-751-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W MEMORIAL",
            "address_2": "SUITE 221",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-755-5801",
            "fax_number": "405-755-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "VERONIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-755-5801",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "20879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "800522305",
            "state": "OK"
        }
    ],
    "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 Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.