NPIMap

Individual provider Active NPI

Jordan Matli, PA-C

  • Physician Assistant
  • Yukon, OK
National Provider Identifier
1285141028
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2825 Issued in OK
Practice address
1651 Professional Cir
Yukon, OK 73099-6314
Phone
(405) 350-6770
NPI assigned
Jan 2, 2018
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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 2825 OK Primary

Addresses

Primary practice location

1651 Professional Cir
Yukon, OK 73099-6314

Mailing address

18505 Auburn Meadows Dr
Edmond, OK 73012-0612
Phone (405) 822-5922

Other names 1

  • Jordan Eckrote Former name

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
I20180308001215 OK Practitioner - Physician Assistant 6103187182 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sja Medical PLLCGroup PAC ID 4082081757, 3 clinicians
Ortho CentralGroup PAC ID 9830526615, shared by 4 NPIs, 33 clinicians

Practice addresses (Care Compare)

13601 W Memorial Park Dr
Suite 300
Oklahoma City, OK 73120-8375
Phone (572) 746-6746

3400 W Tecumseh Rd
301 Ortho Central Surgery Center
Norman, OK 73072-1812
Phone (405) 801-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jeckrote236936@direct.integrisok.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 4

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": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1285141028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18505 AUBURN MEADOWS DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730120612",
            "telephone_number": "405-822-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 PROFESSIONAL CIR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996314",
            "telephone_number": "405-350-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLI",
        "first_name": "JORDAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "ECKROTE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.