| Crescent Post Acute Care Pllc | |
|
1111 N Lee Ave Ste 249 Oklahoma City OK 73103-2600 | |
| (405) 594-5848 | |
| (405) 716-4808 |
| Full Name | Crescent Post Acute Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 N Lee Ave Ste 249, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Waqas Hussain (BILLING MANAGER) |
| Authorized Official Contact | 4057968367 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Post Acute Care Pllc 601 Nw 160th St Edmond OK 73013-1025 Ph: (405) 796-8367 | Crescent Post Acute Care Pllc 1111 N Lee Ave Ste 249 Oklahoma City OK 73103-2600 Ph: (405) 594-5848 |
| NPI Number | 1477298958 |
|---|---|
| Provider Enumeration Date | 04/29/2022 |
| Last Update Date | 04/29/2022 |
| Medicare PECOS PAC ID | 4385022391 |
|---|---|
| Medicare Enrollment ID | O20220603000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477298958 | NPI | - | NPPES |
| 200499530A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Matthew Mcgill |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1447543764 PECOS PAC ID: 5294909263 Enrollment ID: I20111201000348 |
| Provider Name | Saud Iqbal Ahmed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558507962 PECOS PAC ID: 5991851131 Enrollment ID: I20131120000644 |
| Provider Name | Lauren D'ann Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821627167 PECOS PAC ID: 2668895178 Enrollment ID: I20200630003044 |
| Provider Name | Sowminya Arikapudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629424874 PECOS PAC ID: 0446659619 Enrollment ID: I20210521000012 |
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Board Of Regents Of The Univ Of Okla Ou Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 | |