PACE Contract Services for Participant Care

Transcription

1 All Medical Services: Hospital and Clinic care including O/P and ancilliary services & Primary Care Physician PACE Contract Services for Participant Care Cherokee Nation Health Facilities P.O. Box 948 Tahlequah, OK Phone: Contact: Elizabeth Fisher Contract Services Evergreen signed: Ambulance Cherokee Nation EMS PO Box 948 Contact: Elizabeth Fisher Contract Services Evergreen signed: Ambulance Anesthesiology, Radiology, Laboratory tests, x- rays and other diagnostic proceedures, Semiprivate room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services, Medical surgical/intensive care/coronary unit, proceedures, Blood and blood derivatives, Surgical care, including the use of anesthesia Assisted Living Audiology Muskogee County EMS 200 Callahan St Phone: Tahlequah City Hospital 1400 East Downing Phone: Technical Component, ER, Anesthetic/CRNA and TMG Physicians Go Ye Village Inc 1201 W. 4th St Childers Medical Group/ENT 1203 East Ross Bypass Evergreen signed: Evergreen signed: Audiology, Hearing Aids Cardiology Cardiology Northeastern State University Speech Language Pathology and Audiology Karen Ann Patterson, Ph.D 600 Grand Avenue, Phone: Heart Institute of Tulsa 802 S. Jackson, Suite 200 Tulsa, OK George Cohlmia, MD Cardiovascular Specialists 2028 Mahaney Ave. Tahlequah, OK Evergreen signed: Contact: Shelly Dr. Larry Dullye, DO Evergreen signed: Evergreen signed: Contact: Cathy

2 Cardiology Cardiology-detailed list of physicians on N drive Chart Review Chiropractic James R. Higgins, MD Evergreen signed: E. 31st Court, Suite 320 Tulsa, OK Att: Janet Goodman x214 jgoodman@jrhmdheart.com Oklahoma Heart Institute-Ardent Evergreen Signed: 12- Health Services 1265 S. Utica Ave, Suite 300 Tulsa, OK Todd Mapes, D.O. Evergreen signed: N. Eastern Avenue #2303 Edmond, OK Chart Review Services Abels Chiropractic Centre Inc. Evergreen signed: N. Water Ave Corrective Vision Devices Dentistry Dermatology Dentures NSU School of Opthamology Dr. Castillo 600 N. Grand Tom McConnell, D.D.S West 4th Street Suite A Phone: Steven A. Smith, M.D East 81st Street Tulsa, OK PH: Denture and Dental Services P.O. Box Grove, OK KCI USA, Inc IH 10 W San Antonio, TX Phone: Lincare Inc. (United Medical) U.S. 19, N Clearwater, FL Evergreen signed: Evergreen signed: 11- Evergreen signed: Evergreen: signed Three year contract. Signed 4/2/14. Will expire 4/2/17. Evergreen signed: Contact: Cynthia Shaver, Contract Administrator ext 8285 cshaver@lincare.com

3 Medic-Aire of Tahlequah, Inc S. Muskogee Ave. Phone: Medical Equipment Affiliates, 1012 East Downing, , Steve Carey Midwest Medical Services, Inc West 95th Street Lenexa, KS Evergreen signed: Contact: DeAnn Garrison Evergreen signed: Evergreen signed: Contact: Robbie Brady, C.Ped Emergency Response Emergency Response Gastroenterology Gynecology Mobility Plus, Inc North Main Phone: Progressive Orthotics & Prosethetic 311 South York AMA Lifeline P.O. Box Ft. Smith, AR Emergency Alert Response Systems Inc E. 101 St PMB456 Tulsa, OK Dr. Sangal and Dr. Ford Muskogee Digestive Center 384 South 33rd St. #B Phone: Jeanna Rogers, D.O., Deanna Wright N.P. Women's Health A.R.N.P with TMG 1201 E. Ross Bypass Road Phone: Evergreen signed: Evergreen signed: Evergreen signed: Expires: Evergreen signed: Carter Healthcare Attn: Pharmacy 3105 S. Meridian Ave. Oklahoma City, OK Call: Attn: Titus Carey Evergreen signed:

4 Cherokee Nation Home Health Outreach 1Plaza South Tahlequah, OK Evergreen signed: Home Health-Pallative Care - Skilled Nursing Cornerstone Healthcare Inc. P.O. Box 2050 Tahlequah, OK Country Style Health Care Inc NW Hwy 2 Wilburton, OK Local Phone: HealthCare Innovations 103 N. Walnut Sallisaw, OK Local Phone: Oklahoma Healthcare Solutions A division of Country Style Health Care 1011 S. Muskogee Outreach Home Services, LLC 2303 S. York Local Phone: Evergreen signed: Evergreen signed Evergreen signed: Evergreen signed Evergreen signed: Jeannie Frost, Administrator Oxford Healthcare Evergreen signed: N. Hemlock Circle Broken Arrow, OK (Patty Holderman) Traditions Home Care, Inc. 100 S 3rd Street McAlester, OK Hometown Hospice 2307 S. York Evergreen signed: Evergreen signed: Home Health-Pallative Care - Skilled Nursing Hospice of the Cherokees c/o Cherokee Nation Home Health Outreach 1Plaza South T hl h OK Evergreen signed:

5 Home Health-Pallative Care - Skilled Nursing Rivercross Hospice 222 South 32nd Street Muskogee, OK Evergreen signed: Hospital-Muskogee Regional Medical Center- Two Campuses Muskogee Regional Medical Center 300 Rockefeller Drive Muskogee Community Hospital 2900 North Main Street Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services, Medical surgical/intensive care/coronary unit, Laboratory tests, x-rays and other diagnostic proceedures, Blood and blood derivatives, Surgical care, including the use of anesthesia Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services, Medical surgical/intensive care/coronary unit, Laboratory tests, x-rays and other diagnostic proceedures, Blood and blood derivatives, Surgical care, including the use of anesthesia Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services, Medical surgical/intensive care/coronary unit, Laboratory tests, x-rays and other diagnostic proceedures, Blood and blood derivatives, Surgical care, including the use of anesthesia AHS Bailey Medical Center N. 110th E. Ave. Owasso, OK AHS Claremore Regional Hospital 1202 N Muskogee Place Claremore, OK AHS Cushing Regional Hospital 1027 E. Cherry St. Cushing, OK

6 Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services, Medical surgical/intensive care/coronary unit, Laboratory tests, x-rays and other diagnostic proceedures, Blood and blood derivatives, Surgical care, including the use of anesthesia Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Hospital Hospital-Anesthesiology, Radiology, proceedures, Semi-private room and board, General medical and nursing services, Emergency room care and treatment room services, Rehabilitative Services, Psychiatric Services Medical surgical/intensive Hospital AHS Henryetta Medical Center PO Box 1269 Henryetta, OK AHS Hillcrest Medical Center 1120 S. Utica Avenue Tulsa, OK Saint Francis Hospital Tulsa and Broken Arrow Campus 6600 S. Yale Ave. Tulsa, OK AHS Southcrest Hospital 8801 S 101st E Ave Tulsa, OK Tahlequah City Hospital 1400 East Downing Tahlequah, Ok Phone: Evergreen signed: Hospital Hospital-Hospital Operated Physician Group- Ardent Health Services Hospitalist Wagoner Community Hospital 1200 West Cherokee Wagoner, OK Oklahoma Physicians Group-Utica Park Clinic (Ardent Health Services) *refer to N drive for physician roster 1145 S. Utica, Suite 110 Tulsa, OK Mid West Hospitalist Service, PLLC 607 South Broadway Coweta, OK Evergreen signed: Contact: Johnna Blair Evergreen signed:

7 Interdisciplinary Assessment Treatment Planning, Physician Services, Nursing Services, Social Work, Activities and Recreation, Physical, speech, occupational, and recreational therapies, Social serivces Internal Medicine Cherokee Elder Care 1387 W. 4th Street Tahlequah, Ok Phone: Ok Center For Arthritis Therapy & Research Inc Terrace Dr. Tulsa, OK N/A Dr. McKay Contact: Ronnie Expires: Laboratory Meals Meals Meals Nephrology Neurologist Tulsa Medical Lab, LLC; Lab Medicine of Tulsa 2738 E. 51st Ste: 290 Tulsa, OK Go Ye Village Inc 1201 W. 4th St SAC Nutrition P.O. Box 1367 Muskogee, OK C.A.R.D.S. Sr. Nutrition P.O. Box 947 Claremore, OK James Madison, MD Office Medics, Inc. with TMG 1500 E. Downing, Suite 102 Phone: Charles William Lutton, MD 333 S. 38th St Eastgate Village 3500 Haskell Blvd Muskogee, OK Fort Gibson Nursing Home 205 East Popular Street Fort Gibson, OK Evergreen signed: Evergreen signed: Evergreen signed: Contact: Carol Thomas Evergreen signed: Evergreen signed: Expires: Contact: Holly Harris Evergreen signed:

8 Grace Living Center- University NW P.O. Box Grace Living Center Muskogee Oklahoma 4717 W. Okmlugee Grace Living Center East Shawnee P.O. Box Brentwood Extended Care & Rehab 841 N. 38th Street Broadway Manor Nursing Center 1622 E. Broadway Evergreen signed: Evergreen signed: Evergreen signed: Evergreen signed: Moe Worthen Evergreen signed: York Manor 500 South York Cherokee County 1504 N Cedar Ave. Phone: Skiatook Nursing Home, LLC 318 S. Cherry Skiatook, OK Quail Ridge Living Center 564 State Line Road Colcord, OK Phone: Stilwell Nursing Home P.O. Box 651 Stilwell, OK Phone: Fax: Evergreen signed: Bill White Contact: Mark Evergreen: signed Evergreen signed: Contact Finance before admission Evergreen signed: Evergreen signed: Oncology Dr. Ravikumar Vesireddy Pinnacle Oncology 301 N. 32nd St. Phone: Evergreen signed: Contact: Ext. 197

9 Oncology Ophthalmology Daniel Murphy, MD NE Oklahoma Cancer Center 341 S. 33rd Street Triad Eye Medical Clinic 3131 Military Blvd Associated with MRMC & TCH Evergreen signed: Contact: Evergreen Signed: Ophthalmology Ophthalmology Optometry Optometry Optometry Oral surgery NSU School of Optometry Dr. Castillo 600 N. Grand Phone: Britton Vision Associates (Dr. Friesburg) P.O. Box Edmond, OK Debbie S. Coy, OD, PC 330 W Hwy 62 Ft. Gibson, OK Hatfield Family Eye Care 3040 S. Muskogee Ave. Suite Kate L. Miller OD LLC 1640 W. Keetoowah St Tom McConnell, D.D.D West 4th Street Suite A Phone: Evergreen signed: Richard E. Castillo, D.O. Evergreen signed: Contact: Judy Jones Evergreen signed: Evergreen signed: Evergreen signed: Evergreen signed: 11- Orthopedic surgery Tahlequah Orthopedic Surgery Christopher Sarrett DeLoache, D.O E. Boone Street, Suite 3401 Evergreen signed:

10 Otrolaryngology Childers Medical Group/Allergy 1203 E. Ross Bypass Tahlequah, OK Phone: Outpatient/Residential Rehab Therapy Pharmacy, Drugs and Biologicals Monarch, Inc. Residential 501 Fredonia Outpatient/Community Living 2310 W. Broadway CareKinesis 110 Marter Ave., Suite 309 Moorestown, NJ Evergreen signed: Evergreen: Pharmacy, Drugs and Biologicals Catamaran 4525 Executive Park Drive,Suite 100 Montgomery, AL Evergreen: Physical Therapy, Occupational Therapy Rick Risenhoover Physical Therapist Assessments and some therapy Evergreen signed: Physical Therapy, Occupational Therapy Physical Therapy, Occupational Therapy, Home Health Services ViaCare Therapy Services, LLC 8520 S. 36th Terrace Ft. Smith, AR Cherokee Nation Home Health Outreach One Plaza South,PMB #374 Sharon Cox Rehab Care Evergreen signed: Contact: Derek Goodlin, President Stine & Associates 8520 S. 36th Terrace Ft. Smith, AR Evergreen signed:

11 Physician/SNF Cherokee County 1504 N Cedar Ave. Phone: Contact: Mark Evergreen signed: Plastic surgery Justin Plaxico Office Medics Inc, with TMG 3101 Chandler Rd. #105 Podiatry Prosthetics Prosthetics Psychiatry Psychiatry LSI Foot Clinic 215 Woodlawn Ave. Dr. Reed Burk, Dr. Juliet Burk Hanger Prosthetics 1510 Shawnee Cir Progressive Orthotics & Prosethetic 311 South York Peoples Inc. 205 S. J.T. Stites Sallisaw, OK Creoks, Inc. 711 S. Muskogee Ste. 1 Tahlequah, OK Evergreen signed: Evergreen signed: Evergreen signed: Evergreen signed: Sallisaw: Contact: Todd Self Evergreen signed: Pulmonary disease Radiation/Oncology Muskogee Pulmonary Clinic 615 S 32nd St Daniel Murphy, MD NE Oklahoma Cancer Center 341 S. 33rd Street Contact: Sherri Evergreen signed: Associated with MRMC & TCH Evergreen signed Radiology Diagnostic Imaging Associates Inc S. Garnett Suite 919 Tulsa, OK Evergreen signed

12 Rheumatology Semi-private room and board, Custodial care, Personal Care and assistance Ok Center For Arthritis Therapy & Research Inc Terrace Dr. Tulsa, OK Cherokee County 1504 N Cedar Ave. Phone: Dr. McKay Contact: Ronnie Expires: Contact: Mark Evergreen signed: Speech Therapy Melissa Largent W. 782 Rd Phone: Evergreen signed: Speech Therapy Speech Therapy Northeastern State University Speech Language Pathology and Audiology Karen Ann Patterson, Ph.D 600 Grand Avenue, Phone: Taletha "Annie" Cole Hwy 82 C Evergreen signed: Evergreen signed: Sports Medicine and Pain Management Surgery Transportation Urology Dr. Weaver Muskogee Bone and Joint 209 S. 36th St Dr. Justin Plaxico Office Medics Inc. w. TMG 3101 Chandler Rd. #105 KATS P.O. Box 727 Stigler, OK Phone: Dr. Sizemore Office Medics Inc. w. TMG 3101 Chandler Rd. #105 Evergreen signed: Evergreen signed:

13 Urology Urologic Specialists of Oklahoma, Inc East 48th Street South Tulsa, OK Phone: Evergreen signed: Use of Oxygen Use of Oxygen, Medical supplies and appliances RENEWAL PROCESS IS A DAY WINDOW Mobility Plus, Inc North Main Muskogee, Ok Phone: Medical Equipment Affiliates 1012 East Downing , Steve Carey Evergreen signed: Evergreen signed: