Samuel T Jorden, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4590 Issued in OK

Practice address

6161 S Yale Ave
Tulsa, OK 74136-1902

Phone

(918) 494-1805

Fax

(918) 494-4573

NPI assigned

Jan 7, 2020

Last updated

Jan 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
• Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment Care Compare group NPD
• Care Communications LLC

  dba Saint Francis Trauma Institute

  • Critical Access Hospital
  • Tulsa, OK
  • NPI 1003040767
  Medicare reassignment
• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment
• St. John Physicians, Inc

  dba Siggins Memorial Clinic

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St John Sapulpa, Inc.

  • Critical Access Hospital
  • Sapulpa, OK
  • NPI 1922076603
  Care Compare affiliation
• St. John Broken Arrow, Inc

  dba Ascension St. John Jenks

  • General Acute Care Hospital
  • Broken Arrow, OK
  • NPI 1497988596
  Care Compare affiliation

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1225678378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-1805",
            "fax_number": "918-494-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDEN",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200977960A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jimmy Jordan
• John Walter Jordan IV
• Linda A. Jordan
• Randy Scott Jordan, RPA
• Timothy Jordan Jr.
• Erin Nicole Jorgensen, M.D.
• Hannah Paige Jorgensen
• Joseph J Massad DDS (Joseph J Massad DDS Enterprise)
• Joseph L Proskovec DDS PC Inc
• Ajay Joseph, M.D

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.