| St. Mary's Physician Associates, Llc | |
|
302 N Independence St Suite 300 Enid OK 73701-4097 | |
| (580) 249-3915 | |
| Not Available |
| Full Name | St. Mary's Physician Associates, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 302 N Independence St, Enid, Oklahoma |
| Authorized Official Name and Position | Todd Evans (CFO) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary's Physician Associates, Llc Po Box 3046 Malvern PA 19355-0746 Ph: () - | St. Mary's Physician Associates, Llc 302 N Independence St Suite 300 Enid OK 73701-4097 Ph: (580) 249-3915 |
| NPI Number | 1740302751 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 06/28/2019 |
| Medicare PECOS PAC ID | 3678672276 |
|---|---|
| Medicare Enrollment ID | O20070622000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740302751 | NPI | - | NPPES |
| 200111620A | Medicaid | OK | |
| DF9671 | Other | OK | RR MEDICARE |
| Provider Name | John J Bartolozzi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366445876 PECOS PAC ID: 6709770902 Enrollment ID: I20040212000741 |
| Provider Name | Dennis Mcintyre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407840846 PECOS PAC ID: 5092793554 Enrollment ID: I20040710000393 |
| Provider Name | Cristopher D Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881693752 PECOS PAC ID: 7012964604 Enrollment ID: I20050523000896 |
| Provider Name | James M Pontious |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457398141 PECOS PAC ID: 2668497801 Enrollment ID: I20051006001036 |
| Provider Name | Daniel D Washburn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013901461 PECOS PAC ID: 9032139829 Enrollment ID: I20051212000718 |
| Provider Name | David A Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053409052 PECOS PAC ID: 0345249306 Enrollment ID: I20061220000521 |
| Provider Name | Samantha C Moery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578611935 PECOS PAC ID: 7012018021 Enrollment ID: I20070720000416 |
| Provider Name | Christopher M Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548389240 PECOS PAC ID: 0345131868 Enrollment ID: I20070927000388 |
| Provider Name | Rolfe D Reitz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851376602 PECOS PAC ID: 5597832691 Enrollment ID: I20080917000262 |
| Provider Name | Charles W Ferrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427256106 PECOS PAC ID: 1355417858 Enrollment ID: I20090316000694 |
| Provider Name | Richard Rivers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609965136 PECOS PAC ID: 3375623556 Enrollment ID: I20090625000271 |
| Provider Name | Michael R Grossman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538158233 PECOS PAC ID: 1355394743 Enrollment ID: I20091211000021 |
| Provider Name | Michael J O'quin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053401604 PECOS PAC ID: 0244310431 Enrollment ID: I20100302000041 |
| Provider Name | Edgar A Fike |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457431082 PECOS PAC ID: 4880736024 Enrollment ID: I20100416000138 |
| Provider Name | Brooke K Stough |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376794776 PECOS PAC ID: 3274701917 Enrollment ID: I20120822000506 |
| Provider Name | James Daniel Stough |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003043423 PECOS PAC ID: 9931357316 Enrollment ID: I20120910000090 |
| Provider Name | Martin Craig Bozeman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568421253 PECOS PAC ID: 7315076049 Enrollment ID: I20140207000737 |
| Provider Name | David Wade Shepherd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235279746 PECOS PAC ID: 6305064171 Enrollment ID: I20140820002436 |
| Provider Name | Renah T Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972947943 PECOS PAC ID: 0143463950 Enrollment ID: I20141103001454 |
| Provider Name | Emily Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003182650 PECOS PAC ID: 5496986556 Enrollment ID: I20150819006446 |
| Provider Name | Rebecca D Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598039679 PECOS PAC ID: 0749596245 Enrollment ID: I20150828001281 |
| Provider Name | Timothy Jones |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063424331 PECOS PAC ID: 1456304666 Enrollment ID: I20160208001786 |
| Provider Name | Casey L Cochran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821433681 PECOS PAC ID: 5991097693 Enrollment ID: I20160715000559 |
| Provider Name | Melanie Elizabeth Hutchinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861872905 PECOS PAC ID: 9537445598 Enrollment ID: I20170406001242 |
| Provider Name | Jennifer Webber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245757152 PECOS PAC ID: 0244505402 Enrollment ID: I20171013002878 |
| Provider Name | Laura J Hofferber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225548647 PECOS PAC ID: 6002175957 Enrollment ID: I20180122002468 |
| Provider Name | Tayyaba Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700292356 PECOS PAC ID: 4981968492 Enrollment ID: I20180509003021 |
| Provider Name | Brittanye Kayleen Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821563834 PECOS PAC ID: 6800140997 Enrollment ID: I20181107003200 |
| Provider Name | Mohan Mallikarjuna Edupuganti |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164737490 PECOS PAC ID: 3173830981 Enrollment ID: I20191031002681 |
| Provider Name | Christopher Hutchinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720513104 PECOS PAC ID: 6305261322 Enrollment ID: I20200806003277 |
| Provider Name | Nikunjkumar Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740388396 PECOS PAC ID: 3779489810 Enrollment ID: I20210607000193 |
| Provider Name | Charisse J Ward |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528243300 PECOS PAC ID: 4688729601 Enrollment ID: I20210608000808 |
| Provider Name | Lior N Shamai |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093963563 PECOS PAC ID: 7315189016 Enrollment ID: I20211011000672 |
| Provider Name | Mehmet Cilingiroglu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710922125 PECOS PAC ID: 8022036110 Enrollment ID: I20220811003317 |
| Provider Name | Brian Eades |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1538151170 PECOS PAC ID: 4183608664 Enrollment ID: I20221021000980 |
| Provider Name | Sanjay Bhargava |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891734083 PECOS PAC ID: 2668484551 Enrollment ID: I20221101001298 |
| Provider Name | Robert S Emerick |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255315495 PECOS PAC ID: 1850332842 Enrollment ID: I20221104002816 |
| Provider Name | John Burke |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235519935 PECOS PAC ID: 3476821539 Enrollment ID: I20230112000425 |
| Provider Name | Phonekeo Khamvanthong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750519922 PECOS PAC ID: 2264658004 Enrollment ID: I20230213000691 |
| Provider Name | Scott C Carollo |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1760459093 PECOS PAC ID: 7113082744 Enrollment ID: I20231220001440 |
Integris Nw Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 S Madison St, Suite 209, Enid, OK 73701 Phone: 580-548-1544 Fax: 580-548-1590 | |
Advance Food Company Employee's Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 E Garriott Rd, Suite D, Enid, OK 73701 Phone: 580-234-8998 Fax: 580-234-8465 | |
Enid Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 S Madison St, Suite 304, Enid, OK 73701 Phone: 580-242-1300 Fax: 580-237-7913 | |
Daniel D. Washburn, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1815 E Maple Ave, Enid, OK 73701 Phone: 580-242-1881 Fax: 580-234-2090 | |
Care Pathways, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 S 5th St Ste 206, Enid, OK 73701 Phone: 405-928-2727 Fax: 405-928-2720 | |
Reliant Health & Wellness Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 822 W Randolph Ave, Enid, OK 73701 Phone: 580-599-0272 Fax: 580-603-8602 | |
Parrish Enterprises Employee's Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1414 E Willow Rd, Enid, OK 73701 Phone: 580-237-4033 Fax: 580-237-3455 |