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

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



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

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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

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Nurse Practitioner Nurses in Tulsa, OK

Jennifer Christa Pimentel, ARNP, CPNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6565 S Yale Ave Ste 209, Tulsa, OK 74136
Phone: 918-392-4550    Fax: 918-392-4551
Casie Nicole Brim, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1919 S Wheeling Ave, Suite 606, Tulsa, OK 74104
Phone: 918-748-7676    Fax: 918-293-3130
Jared Qualls, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1145 S Utica Ave, Suite 460, Tulsa, OK 74104
Phone: 918-579-5749    Fax: 918-579-5762
Adekemi Taiwo, APRN - CNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133
Phone: 918-615-3750    
Stephanie Ann Adame, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 12697 E 51st St, Tulsa, OK 74146
Phone: 918-505-3200    
Mrs. Susan Elaine Graham, DNP, APRN, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2408 E 81st St Ste 900, Tulsa, OK 74137
Phone: 918-319-5021    Fax: 918-477-5853

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