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PAUL BRADLEY PLOWMAN M.D.
NPI 1619923463
Obstetrics & Gynecology in Ponca City, OK

Active since May 25, 2006PECOS EnrolledAccepts Medicare Assignment
517 VIRGINIA AVE, PONCA CITY, OK 74601(405) 365-1210 Get Directions Write a Review

NPPES record last updated: October 12, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 12, 2016, Feb 9, 2016 (2 updates tracked since 2016).

About Paul Bradley Plowman M.d. NPPES

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

PAUL BRADLEY PLOWMAN M.D. (NPI 1619923463) is an individual obstetrics & gynecology provider in Ponca City, Oklahoma, licensed in Oklahoma (23548) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Ardmore, Inc, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1619923463
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NamePAUL BRADLEY PLOWMANCredential: M.D.
Location Address517 VIRGINIA AVEPonca City, OK 74601-2954
Mailing Address517 Virginia AvePonca City, OK 74601-2954
Phone(405) 365-1210
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 25, 2006
Last NPPES UpdateOctober 12, 20162 updates tracked since enumeration
✔ NPI 1619923463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in OK · 23548
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
517 VIRGINIA AVE, Ponca City, OK 74601
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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 Sunflower Health Plan, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paul Bradley Plowman M.d. 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 ID4688671274
PECOS Enrollment IDI20061212000331
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Paul Plowman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mercy Clinic Oklahoma Communities
82 mi
Family Medicine
4300 W MEMORIAL RD
Oklahoma City, OK 73120
  • Reassigned Medicare billing, Oklahoma enrollment
  • 975 clinicians in this Medicare group
NPI 1386874550 (405) 752-3333
Northeastern Oklahoma Community Health Centers Inc
102 mi
Federally Qualified Health Center (FQHC)
5319 S MILL ST
Pryor, OK 74361
  • Reassigned Medicare billing, Oklahoma enrollment
  • 65 clinicians in this Medicare group
NPI 1669101184 (918) 772-3390

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

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.
27 services25 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
24 services23 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.
19 services19 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
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 Ardmore, Inc

Acute Care Hospitals · Ardmore, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number370047
Location1011 14th Ave NWArdmore, OK 73401 · Carter County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74601 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
48%104 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
67%334 patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
26%432 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 215 patients
78%215 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Paul Plowman's NPI number?

The NPI number for Paul Plowman is 1619923463. It was assigned to this individual provider in the NPPES registry on May 25, 2006.

Where is Paul Plowman located?

Paul Plowman practices at 517 Virginia Ave, Ponca City, OK 74601. The listed phone number is (405) 365-1210.

What is Paul Plowman's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Paul Plowman enrolled in Medicare?

Yes. Paul Plowman 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.

Which organizations bill Medicare for Paul Plowman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Plowman reassigns Medicare benefits to 2 organizations: Mercy Clinic Oklahoma Communities (Oklahoma City, OK) and Northeastern Oklahoma Community Health Centers Inc (Pryor, OK). Each 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 Paul Plowman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Plowman accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Paul Plowman 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 Paul Plowman affiliated with any hospitals?

According to CMS data, Paul Plowman is affiliated with Mercy Hospital Ardmore, Inc.

When was this NPI record last updated?

The NPPES record for Paul Plowman was last updated on October 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.