NPIMap

Individual provider Active NPI

Hetlevia R Vilar-Jensen, M.D.

  • Family Medicine Physician
  • Wetumka, OK
National Provider Identifier
1093755266
Registry record updated Nov 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23895 Issued in OK
Practice address
109 S Main St
Wetumka, OK 74883-4015
Phone
(405) 452-5400
Fax
(405) 452-3000
NPI assigned
Jun 7, 2006
Last updated
Nov 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23895 OK Primary

Addresses

Primary practice location

109 S Main St
Wetumka, OK 74883-4015

Mailing address

PO Box 11457
Belfast, ME 04915-4005
Phone (405) 733-0313

Other identifiers 2

IdentifierTypeStateIssuer
200031400AMedicaidOK
200031400BOtherOKSOONERCARE-INDIVIDUAL

Other names 1

  • Hetlevia R Jensen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000314 OK Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 9537147830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

109 S Main St
Wetumka, OK 74883-4015
Phone (405) 452-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23895OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Resource Management, LLC Family Medicine CurrentSince Sep 26, 2014 Accepting new patients
East Central Oklahoma Family Health Center, Inc. Current Accepting new patients
East Central Oklahoma Family Health Center, Inc. CurrentSince Apr 2, 2018 Accepting new patients
East Central Oklahoma Family Health Center, Inc. CurrentSince Apr 2, 2018 Accepting new patients
Midwest Regional Medical Center, LLC PastSince Jun 1, 2013 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

104 E Shurden Industrial Blvd
Henryetta, OK 74437
Phone (918) 652-9614

1102 W Main St
Henryetta, OK 74437
Phone (918) 652-9614

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

109 S Main St
Wetumka, OK 74883
Phone (405) 452-5400

Interoperability endpoints

  • Direct secure messaging: hetlevia.vilarjensen@330813548658692.direct.elationemr.com
  • Direct secure messaging: hjensen@ecofhc.directbygreenway.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1093755266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11457",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154005",
            "telephone_number": "405-733-0313",
            "fax_number": "405-733-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST",
            "city": "WETUMKA",
            "state": "OK",
            "postal_code": "748834015",
            "telephone_number": "405-452-5400",
            "fax_number": "405-452-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILAR-JENSEN",
        "first_name": "HETLEVIA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031400A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOONERCARE-INDIVIDUAL",
            "identifier": "200031400B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HETLEVIA",
            "last_name": "JENSEN",
            "middle_name": "R",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wetumka, OK

Sources for this page

Verify at the official NPI Registry.