SUNNYLANE MEDICAL CLINIC LLC
NPI 1255922811
Family Medicine in Del City, OK
About Sunnylane Medical Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUNNYLANE MEDICAL CLINIC LLC (NPI 1255922811) is a healthcare organization registered as a family medicine in Del City, Oklahoma and active in the NPI registry since January 2021. The organization lists Braden Peterson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sunnylane Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Sunnylane Medical Clinic LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sunnylane Medical Clinic LLC's NPI number?
The NPI number for Sunnylane Medical Clinic LLC is 1255922811. It was assigned to this organization in the NPPES registry on January 27, 2021.
Where is Sunnylane Medical Clinic LLC located?
Sunnylane Medical Clinic LLC is located at 3916 S Sunnylane Rd, Del City, OK 73115. The listed phone number is (405) 455-5330.
What is Sunnylane Medical Clinic LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sunnylane Medical Clinic LLC enrolled in Medicare?
Yes. Sunnylane Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sunnylane Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Sunnylane Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Sunnylane Medical Clinic LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Sunnylane Medical Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Sunnylane Medical Clinic LLC was last updated on August 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sunnylane Medical Clinic Llc · NPI 1255922811
Family Medicine organization in Del City, Oklahoma. Organization record, active in the CMS NPPES registry since January 27, 2021.
## Identity
- **NPI:** 1255922811 (Entity type: Organization)
- **Enumerated:** January 27, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Braden Peterson, OWNER
## Practice location
- **Address:** 3916 S SUNNYLANE RD, Del City, OK 73115-3656
- **Phone:** (405) 455-5330
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 14, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1255922811) · Data from the CMS NPPES public registry.