NPIMap

Individual provider Active NPI

Samuel Isaac Bethea, PA-C

  • Physician Assistant
  • Claremore, OK
National Provider Identifier
1992193676
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2431 Issued in OK
Practice address
1071 W Blue Starr Dr Ste 105
Claremore, OK 74017-2869
Phone
(918) 361-0600
Fax
(918) 927-3201
NPI assigned
Jan 2, 2015
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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 2431 OK Primary

Addresses

Primary practice location

1071 W Blue Starr Dr Ste 105
Claremore, OK 74017-2869

Mailing address

2488 E 81St St Ste 290
Tulsa, OK 74137-4299
Phone (918) 927-3226

Other identifiers 1

IdentifierTypeStateIssuer
200570050AMedicaidOK

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
I20150130000962 OK Practitioner - Physician Assistant 0941524581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics of Oklahoma PLLCGroup PAC ID 8426320912, 90 clinicians

Practice addresses (Care Compare)

1071 W Blue Starr Dr
Suite 105
Claremore, OK 74017-2869
Phone (918) 641-0600

205 E B St
Jenks, OK 74037-3906
Phone (918) 299-7937

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Claremore Regional Hospital, LLC. Past Accepting new patients

Organizations & group practices 2

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 7

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1992193676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374299",
            "telephone_number": "918-927-3226",
            "fax_number": "918-927-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 W BLUE STARR DR STE 105",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740172869",
            "telephone_number": "918-361-0600",
            "fax_number": "918-927-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "SAMUEL",
        "middle_name": "ISAAC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200570050A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.