Active NPI
Nick Jansen, PA-C
- Medical Physician Assistant
- Rota, MP
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2161
- Practice address
- Songsong Village
Rota, MP 96951-1249 - Phone
- (670) 532-9461
- Fax
- (670) 532-0698
- NPI assigned
- Aug 6, 2012
- Last updated
- Oct 23, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2161 | OK | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
Songsong Village
Rota, MP 96951-1249
Mailing address
PO Box 1249
Rota, MP 96951-1249
Phone (670) 532-9461
Other practice location 1
31870 E State Highway 51
Coweta, OK 74429-7900
Phone (918) 279-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX, MP
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Lower Navy Hill Rd
Saipan, MP 96950
Phone (670) 234-8950
PO Box
Saipan, MP 96950
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.12 of 100
- Quality
- 83.76
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 56.64
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2161 | OK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Healthcare Corporation | Current | Accepting new patients | |
| Rota Health Center Pharmacy | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Commonwealth Healthcare Corporation | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | Accepting new patients |
Locations
31870 E State Highway 51
Coweta, OK 74429
Phone (918) 279-3200
1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641
900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448
1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310
10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760
Dept 1467
Tulsa, OK 74182
Interoperability endpoints
- njansen17979@muscogeecreeknation.direct-ci.com
Organizations & group practices 8
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.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Saipan, MP
- NPI 1285858290
-
dba Creek Nation Community Hospital
- Family Medicine Physician
- Okemah, OK
- NPI 1467053173
TX
-
dba Creek Nation Health System
- Clinic/Center
- Muskogee, OK
- NPI 1366593923
-
dba Tinian Health Center
- Rural Health Clinic/Center
- Tinian, MP
- NPI 1003382854
-
- General Acute Care Hospital
- Saipan, MP
- NPI 1871616292
-
- Community/Retail Pharmacy
- Rota, MP
- NPI 1205457199
-
dba Muscogee (Creek) Nation Long Term Acute Care Hospital
- Long Term Care Hospital
- Okmulgee, OK
- NPI 1376979955
-
dba Muscogee Healing and Recovery Center
- Clinic/Center
- Muskogee, OK
- NPI 1922873611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761177600000",
"number": "1306193727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1249",
"city": "ROTA",
"state": "MP",
"postal_code": "969511249",
"telephone_number": "670-532-9461",
"fax_number": "670-532-0698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SONGSONG VILLAGE",
"city": "ROTA",
"state": "MP",
"postal_code": "969511249",
"telephone_number": "670-532-9461",
"fax_number": "670-532-0698"
}
],
"practiceLocations": [
{
"address_1": "31870 E State Highway 51",
"address_purpose": "LOCATION",
"city": "Coweta",
"state": "OK",
"postal_code": "744297900",
"country_code": "US",
"telephone_number": "918-279-3200",
"fax_number": "918-279-1101",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JANSEN",
"first_name": "NICK",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-06",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OK",
"license": "2161",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rota, MP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.