NPIMap

Individual provider Active NPI

Jantzen Matli, DO

  • Family Medicine Physician
  • McAlester, OK
National Provider Identifier
1205337201
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6704 Issued in OK
Practice address
1401 E Van Buren Ave
McAlester, OK 74501-4245
Phone
(918) 421-8440
Fax
(918) 421-8750
NPI assigned
Feb 24, 2018
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T1459 TX
Family Medicine Physician 207Q00000X 6704 OK Primary

Addresses

Primary practice location

1401 E Van Buren Ave
McAlester, OK 74501-4245

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (918) 499-4855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200813001781 TX Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2961828595 Reassigns benefits to 1 organization
I20250625001228 OK Practitioner - Family Practice 2961828595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

1401 E Van Buren Ave
McAlester, OK 74501-4245
Phone (918) 426-0240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Aug 4, 2025 Accepting new patients
Coryell County Memorial Hospital Authority CurrentSince Jul 1, 2021 Accepting new patients
Coryell County Memorial Hospital Authority CurrentSince Jul 1, 2021 Accepting new patients
Coryell County Memorial Hospital Authority Current Accepting new patients
Coryell County Memorial Hospital Authority Past Accepting new patients

Locations

1401 E Van Buren Ave
McAlester, OK 74501
Phone (918) 421-8440

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

1507 W Main St
Gatesville, TX 76528
Phone (254) 865-8251

Interoperability endpoints

  • Direct secure messaging: drjmatli@cmhs.securechart.com
  • Direct secure messaging: jmatli115087@direct.saintfrancis.com

Organizations & group practices 5

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 6

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": "1519430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1205337201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "918-499-4855",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E VAN BUREN AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014245",
            "telephone_number": "918-421-8440",
            "fax_number": "918-421-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLI",
        "first_name": "JANTZEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-24",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T1459",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.