ELISSA SY (AG-ACNP, APRN-CNP) – Acute Care Nurse Practitioner, NPI 1003650888

ELISSA SY (AG-ACNP, APRN-CNP) is a healthcare provider. based in Bixby, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials AG-ACNP, APRN-CNP. They hold a License No. 218715 (OK). The NPI Number for ELISSA SY (AG-ACNP, APRN-CNP) is 1003650888

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ELISSA SY (AG-ACNP, APRN-CNP)
NPI
1003650888
Phone
(918) 695-1278
Address
14429 S HUDSON AVE
Enumeration Date
25 June 2024
Last Update Date
25 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185792300
Graduation Year
2024 (2 years ago)
PAC ID
5092249110
Group Practice PAC ID
7214327832
Professional Enrollment ID
I20241113000022
Address ID
OK740556655OW10502AVEX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for ELISSA SY (AG-ACNP, APRN-CNP)

  • 14429 S HUDSON AVE

    BIXBY, OK 740084074

    Phone: (918) 695-1278

    Type: Mailing

  • 1120 S UTICA AVE

    TULSA, OK 741044090

    Phone: (918) 579-1000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241113000022INurse PractitionerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74008)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214327832View full group profile
NameSpecialtyState
Nurse PractitionerOK
Internal MedicinePA
Nurse PractitionerOK
Nurse PractitionerOK
Internal Medicine, Hospice/Palliative CareOK
Nurse PractitionerOK
Physician AssistantOK
Internal MedicineOK
Family PracticeOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Where can patients find ELISSA SY (AG-ACNP, APRN-CNP)'s NPI?
You can confirm ELISSA SY (AG-ACNP, APRN-CNP) with NPI 1003650888; it appears in the national provider directory.
Is ELISSA SY (AG-ACNP, APRN-CNP)'s NPI currently valid?
The extract we use shows ELISSA SY (AG-ACNP, APRN-CNP) as active.
Can you summarize ELISSA SY (AG-ACNP, APRN-CNP)'s specialty in plain language?
Clinically, the directory lists ELISSA SY (AG-ACNP, APRN-CNP) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is ELISSA SY (AG-ACNP, APRN-CNP)'s primary listing?
We display Bixby, Oklahoma because that is what the record indicates for ELISSA SY (AG-ACNP, APRN-CNP).
How can I contact ELISSA SY (AG-ACNP, APRN-CNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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