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MRS. MARY ILLIG MINIELLY APRN
NPI 1417086380
Nurse Practitioner in Oklahoma City, OK

Active since March 05, 2007PECOS Enrolled
8100 S. WALKER AVENUE, BUILDING A, OKLAHOMA CITY, OK 73139(405) 632-4468(405) 631-4964 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Mary Illig Minielly Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARY ILLIG MINIELLY APRN (NPI 1417086380) is an individual nurse practitioner in Oklahoma City, Oklahoma, licensed in Oklahoma (R0059137) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417086380
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. MARY ILLIG MINIELLYCredential: APRN
Location Address8100 S. WALKER AVENUE, BUILDING AOklahoma City, OK 73139-9404
Mailing Address8100 S. Walker Avenue, Building AOklahoma City, OK 73139-9404 · (405) 632-4468 · Fax (405) 631-4964
Phone(405) 632-4468
Fax(405) 631-4964
Sole ProprietorNo
Enumeration DateMarch 5, 2007
Last NPPES UpdateMarch 7, 2023
✔ NPI 1417086380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OK · R0059137
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License R0059137 (OK)
8100 S. WALKER AVENUE, Oklahoma City, OK 73139
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Other Identifiers 6

Other100130740AOK · Ohca
Other28812OK · Onbdd
Other100130740AOK · Soonercare
Other12317438OK · Caqh
Other1417086380OK · Npi
Other59137OK · License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mary Illig Minielly Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73139 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mary Minielly's NPI number?

The NPI number for Mary Minielly is 1417086380. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Where is Mary Minielly located?

Mary Minielly practices at 8100 S. Walker Avenue Building A, Oklahoma City, OK 73139. The listed phone number is (405) 632-4468.

What is Mary Minielly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mary Minielly enrolled in Medicare?

Yes. Mary Minielly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Minielly was last updated on March 7, 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.