DR. JUSTIN B PLAXICO D.O.
NPI 1518996958
Surgery in Ada, OK

Q: What is Justin Plaxico's NPI number?

The NPI number for Justin Plaxico is 1518996958. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Q: What is Justin Plaxico's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Plaxico was last updated on August 11, 2022. 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.

Active since June 30, 2006PECOS EnrolledAccepts Medicare Assignment

435 N MONTE VISTA ST, ADA, OK 74820(580) 310-0102(580) 310-0104 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 11, 2022, Oct 30, 2019, Aug 2, 2018 (3 updates tracked since 2018).

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About Dr. Justin B Plaxico D.o. NPPES

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

DR. JUSTIN B PLAXICO D.O. (NPI 1518996958) is an individual surgery provider in Ada, Oklahoma, licensed in Oklahoma (3875) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Ada, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2000).

NPPES Registry Identity

NPI1518996958

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. JUSTIN B PLAXICOCredential: D.O.

Location Address435 N MONTE VISTA STAda, OK 74820-4676

Mailing Address435 N Monte Vista StAda, OK 74820-4676 · (580) 310-0102 · Fax (580) 310-0104

Phone(580) 310-0102

Fax(580) 310-0104

Sole ProprietorNo

Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2000

Enumeration DateJune 30, 2006

Last NPPES UpdateAugust 11, 20223 updates tracked since enumeration

NPPES CertifiedAugust 11, 2022

✔ NPI 1518996958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in OK · 3875

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

435 N MONTE VISTA ST, Ada, OK 74820

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Justin B Plaxico D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820079452

PECOS Enrollment IDI20040528000222

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 14

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

66 services64 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

60 services60 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

53 services51 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

49 services48 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

45 services45 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

40 services40 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

36 services29 patients

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

34 services34 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

31 services29 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

24 services24 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

18 services18 patients

Removal of gallbladder with x-ray study of bile ducts using an endoscope 47563

This procedure, known as an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible camera (endoscope) to examine your bile ducts. If gallstones are found, your gallbladder may be removed in a separate procedure. This helps prevent future complications.

14 services14 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Ada

Acute Care Hospitals · Ada, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370020

Location430 North Monte VistaAda, OK 74820 · Pontotoc County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74820 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

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CELESTE COLEEN ADRIAN M.D.

Surgery

435 N MONTE VISTA ST
ADA, OK 74820

Pontotoc County (580) 310-0102

GHAITH AL-QUDAH M.D.

Surgery

435 N MONTE VISTA ST
ADA, OK 74820

Pontotoc County (580) 310-0102

DOUGLAS THORNTON DO

Surgery

435 N MONTE VISTA ST
ADA, OK 74820

Pontotoc County (580) 310-0102

ADA MRI ASSOCIATES, L.L.C.

Clinic/Center (Magnetic Resonance Imaging (MRI))

435 N MONTE VISTA ST, SUITE B
ADA, OK 74820

Pontotoc County (580) 332-0400

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 Justin Plaxico's NPI number?

The NPI number for Justin Plaxico is 1518996958. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Where is Justin Plaxico located?

Justin Plaxico practices at 435 N Monte Vista St, Ada, OK 74820. The listed phone number is (580) 310-0102.

What is Justin Plaxico's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Justin Plaxico enrolled in Medicare?

Yes. Justin Plaxico is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Justin Plaxico accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Justin Plaxico 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.

Is Justin Plaxico affiliated with any hospitals?

According to CMS data, Justin Plaxico is affiliated with Mercy Hospital Ada.

When was this NPI record last updated?

The NPPES record for Justin Plaxico was last updated on August 11, 2022. 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.