Lisa Michele Sample, AG-ACNP - Medicare Nurse Practitioner in Tulsa, OK

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Lisa Michele Sample, AG-ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Tulsa, Oklahoma. Her current practice location is 6161 S Yale Ave, Tulsa, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (918) 494-2200.

Lisa Michele Sample is licensed to practice in Oklahoma (license number 205023) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003582644.

Contact Information

Lisa Michele Sample, AG-ACNP
6161 S Yale Ave,
Tulsa, OK 74136-1902
(918) 494-2200
Not Available

Map and Direction




Provider's Profile

Full NameLisa Michele Sample
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location6161 S Yale Ave, Tulsa, Oklahoma
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003582644
  • Provider Enumeration Date: 08/23/2021
  • Last Update Date: 01/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6608256185
  • Enrollment ID: I20220629003282

Medical Identifiers

Medical identifiers for Lisa Michele Sample such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003582644NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 205023 (Oklahoma)Secondary
363LA2100XNurse Practitioner - Acute Care 205023 (Oklahoma)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Michele Sample allows following entities to bill medicare on her behalf.
Entity NameWarren Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174582282
PECOS PAC ID: 8820900293
Enrollment ID: O20031104000252

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Michele Sample is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lisa Michele Sample, AG-ACNP
6600 S Yale Ave Ste 1400,
Tulsa, OK 74136-3331

Ph: () -		Lisa Michele Sample, AG-ACNP
6161 S Yale Ave,
Tulsa, OK 74136-1902

Ph: (918) 494-2200

Reviews and Comments


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Adekemi Taiwo, APRN - CNP
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Mrs. Susan Elaine Graham, DNP, APRN, FNP-BC
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Medicare: Accepting Medicare Assignments
Practice Location: 2408 E 81st St Ste 900, Tulsa, OK 74137
Phone: 918-319-5021    Fax: 918-477-5853

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.