Jacinda Hantak, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

96351 Issued in OK

Practice address

4400 Grant Blvd
Yukon, OK 73099-0037

Phone

(405) 603-4660

Fax

(405) 470-3377

NPI assigned

Nov 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  Family, OK

  Medicare reassignment Care Compare group NPD
• The Physicians Group LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1487620381
  Medicare reassignment NPD

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

{
    "created_epoch": "1478995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1184166753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 GRANT BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730990037",
            "telephone_number": "405-603-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 GRANT BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730990037",
            "telephone_number": "405-603-4660",
            "fax_number": "405-470-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANTAK",
        "first_name": "JACINDA",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-13",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "96351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Hampton, OD
• Alecia A Hanes, MD
• Nathan Hanning
• Crystal Hansel-Jackson, RDN
• Miranda Hanson, MS, ATC, LAT
• Kiana Hardwick
• John Paul Hargrove, BA
• Isaac George Harjo, PTA
• Emily Breanna Harmon, RBT
• Allysen Hope Harrington

• Family Nurse Practitioner in Yukon, OK
• Providers in Yukon, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.