Mykena Matheson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5827 Issued in OK

Practice address

3312 S Peoria Ave
Tulsa, OK 74105-2029

Phone

(918) 984-9153

Fax

(539) 430-0051

NPI assigned

Feb 24, 2020

Reactivated

Mar 21, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mykena Nicole Miller Former name

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Oklahoma LLCGroup PAC ID 5496088296, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Empowerme Rehabilitation Oklahoma LLC

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1023514247

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Empowerme Wellness Kansas City, LLC

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1366024077

  Single Specialty

  Medicare reassignment NPD
• Empowerme Wellness Kansas City, LLC

  • Rehabilitation Clinic/Center
  • Liberty, MO
  • NPI 1174299044
  NPD
• Spectrum of Hope, LLC

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1669983409

  Behavior Analyst

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1053945592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052029",
            "telephone_number": "918-984-9153",
            "fax_number": "539-430-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052029",
            "telephone_number": "918-984-9153",
            "fax_number": "539-430-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "MYKENA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "deactivation_date": "2024-03-12",
        "reactivation_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "RBT-19-102208",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "5827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114068822",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYKENA",
            "last_name": "MILLER",
            "middle_name": "NICOLE",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keith D Mather, M.D.
• Benjamin Cole Mathers
• Mark L Mathers, D.O.
• Amanda Lee Mathes
• Keith Matheson
• Divya Mathew
• Diya Mathew
• Jean Mathew, DO
• Jenny Mathew, PHARMD, BCPPS
• Rachel Mathew, APRN-CNP

• Occupational Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.