Jennifer L Berends, DO
Individual provider Active NPI Family Medicine Physician · Shattuck, OK
NPI 1144239229 · NPPES record last updated Jan 25, 2013
Key facts
- NPI
- 1144239229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4504 (OK)
- Practice address
- 416 S Main
Shattuck, OK 73858-0703 - Phone
- (580) 938-5275
- Fax
- (580) 938-2256
- NPI assigned
- Aug 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Oklahoma State University College of Osteopathic Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Newman Memorial Hospital, Inc
Practice addresses (Care Compare)
1000 15TH St
Woodward, OK 73801-3008
Phone (580) 571-3160
416 S Main St
Shattuck, OK 73858-9614
Phone (580) 938-5276
905 S Main
Shattuck, OK 73858-9205
905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551
Hospital & facility affiliations
- Assured Home Health of Woodward
- Accentcare Health
- Traditions Health of Woodward
- Newman Memorial Hospital
- Integris Health Woodward Hospital
- SSM Health St Anthony Hospital - Oklahoma City
- Mercy Hospital Oklahoma City, Inc
- Shattuck Nursing Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.1 of 100
- Quality
- 80.17
- Improvement activities
- 40
- Cost
- 60.12
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 88 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080107000124 | OK | Practitioner - Family Practice | 2769417179 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4504 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients | |
| Shattuck Nursing Center Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FEDDBA/Endpoint/FEDDBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4504 | OK | Yes |
Addresses
Primary practice location
416 S Main
Shattuck, OK 73858-0703
Mailing address
PO Box 703
Shattuck, OK 73858-0703
Phone (580) 938-5275
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200119230A | Medicaid | OK |
Other providers in Shattuck, OK
- Shandy Baggs
- Kerie Bay
- Bryan Wesley Bell
- Richard Phillip Berry
- Robert Bradley Bunch
- Kristen A Burris
- Amy Calhoun-Vasko
- Jamie L Cameron
All providers in Shattuck, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.