Ico Primary Care, Llc - Medicare Primary Care in Choctaw, OK

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Ico Primary Care, Llc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Choctaw, Oklahoma. The current practice location for Ico Primary Care, Llc is 1664 S Choctaw Rd Ste 101, Choctaw, Oklahoma. For appointments, you can reach them via phone at (405) 281-2144. The mailing address for Ico Primary Care, Llc is 5701 Se 74th St Ste E, Oklahoma City, Oklahoma and phone number is (405) 600-6869.

Ico Primary Care, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1568144996. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (405) 281-2144.

Contact Information

Ico Primary Care, Llc
1664 S Choctaw Rd Ste 101
Choctaw
OK 73020-6767
(405) 281-2144
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameIco Primary Care, Llc
SpecialityClinic/Center
Location1664 S Choctaw Rd Ste 101, Choctaw, Oklahoma
Authorized Official Name and PositionKevin Penwell (CMO)
Authorized Official Contact4056006869
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ico Primary Care, Llc
5701 Se 74th St Ste E
Oklahoma City
OK 73135-1110

Ph: (405) 600-6869		Ico Primary Care, Llc
1664 S Choctaw Rd Ste 101
Choctaw
OK 73020-6767

Ph: (405) 281-2144

NPI Details:

NPI Number1568144996
Provider Enumeration Date08/04/2023
Last Update Date06/18/2024

Medicare PECOS Information:

Medicare PECOS PAC ID6901240910
Medicare Enrollment IDO20240219000460

Medical Identifiers

Medical identifiers for Ico Primary Care, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568144996NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ico Primary Care, Llc acts as a billing entity for following providers:
Provider NameKevin M Penwell
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1841286333
PECOS PAC ID: 8325005580
Enrollment ID: I20041220000487
Provider NameJeremy George Tanner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275874026
PECOS PAC ID: 5991944761
Enrollment ID: I20130627000237
Provider NameKelli Le Cox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902370802
PECOS PAC ID: 6709278815
Enrollment ID: I20220124001394
Provider NameJosephine R Otoo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477064335
PECOS PAC ID: 5890865190
Enrollment ID: I20230419000092

Reviews and Comments


Clinic/Center in Choctaw, OK

Healthcare Express, Llp
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Phone: 405-390-9600    Fax: 405-390-9400

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Medicare: Medicare Enrolled
Practice Location: 1940 Harper St, Choctaw, OK 73020
Phone: 405-281-6065    Fax: 405-281-6068

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.