Individual provider Active NPI

Nick Jansen, PA-C

  • Medical Physician Assistant
  • Rota, MP
National Provider Identifier
1306193727
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2161 Issued in OK
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, MP3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130605000608 OK Practitioner - Physician Assistant 8123266939 Reassigns benefits to 1 organization
I20210909003950 TX Practitioner - Physician Assistant 8123266939 Reassigns benefits to 1 organization
I20241003002299 MP Practitioner - Physician Assistant 8123266939 Reassigns benefits to 1 organization

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 100Reported as group
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

LicenseStateTypeSpecialty
2161OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Sep 3, 2024 Accepting new patients
Rota Health Center Pharmacy CurrentSince Nov 7, 2025 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 16, 2013 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jun 5, 2021 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Sep 3, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 16, 2013 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.