Individual provider Active NPI

Joshua David Servantez, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1184442444
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5715 Issued in OK
Practice address
5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090
Phone
(405) 604-8485
Fax
(405) 604-8486
NPI assigned
Sep 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5715 OK Primary

Addresses

Primary practice location

5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090

Mailing address

5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090
Phone (405) 604-8485

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260616000481 OK Practitioner - Physician Assistant 4789156324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

5401 N Portland Ave
Suite 600
Oklahoma City, OK 73112-2121
Phone (405) 713-9940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5715OKMDSpeech-Language Pathologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1184442444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE STE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122090",
            "telephone_number": "405-604-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE STE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122090",
            "telephone_number": "405-604-8485",
            "fax_number": "405-604-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVANTEZ",
        "first_name": "JOSHUA",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.