Active NPI
Jennifer M Acuna, PA-C
- Physician Assistant
- Tulsa, OK
National Provider Identifier
1306981071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1605
- Practice address
- 6839 S Canton Ave
Tulsa, OK 74136-3402 - Phone
- (918) 494-0612
- Fax
- (918) 841-5170
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1605 | OK | Primary |
Addresses
Primary practice location
6839 S Canton Ave
Tulsa, OK 74136-3402
Mailing address
6839 South Canton
Tulsa, OK 74136-3402
Phone (918) 494-0612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200105940A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1605 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Stem Cardiology PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Bartlesville, OK
- NPI 1922014240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1306981071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6839 SOUTH CANTON",
"city": "TULSA",
"state": "OK",
"postal_code": "741363402",
"telephone_number": "918-494-0612",
"fax_number": "918-841-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6839 S CANTON AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741363402",
"telephone_number": "918-494-0612",
"fax_number": "918-841-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACUNA",
"first_name": "JENNIFER",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "1605",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200105940A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.