NPIMap

Individual provider Active NPI

Jennifer L Berends, DO

  • Family Medicine Physician
  • Shattuck, OK
National Provider Identifier
1144239229
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4504 Issued in OK
Practice address
416 S Main
Shattuck, OK 73858-0703
Phone
(580) 938-5275
Fax
(580) 938-2256
NPI assigned
Aug 6, 2006
Last updated
Jan 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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 4504 OK Primary

Addresses

Primary practice location

416 S Main
Shattuck, OK 73858-0703

Mailing address

PO Box 703
Shattuck, OK 73858-0703
Phone (580) 938-5275

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
I20080107000124 OK Practitioner - Family Practice 2769417179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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, IncGroup PAC ID 2567482367, 29 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as individual
Quality
80.17
Improvement activities
40
Cost
60.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions88
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4504OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients
Shattuck Nursing Center Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEDDBA/Endpoint/FEDDBA

Organizations & group practices 4

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 9

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": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1144239229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738580703",
            "telephone_number": "580-938-5275",
            "fax_number": "580-938-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 S MAIN",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738580703",
            "telephone_number": "580-938-5275",
            "fax_number": "580-938-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENDS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-06",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shattuck, OK

Sources for this page

Verify at the official NPI Registry.