Individual provider Active NPI

Chester Alan Hendershot Jr., MHA,MHS, PA-C

  • Physician Assistant
  • Yukon, OK
National Provider Identifier
1326553256
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2821 Issued in OK
Practice address
709 N Czech Hall Rd
Yukon, OK 73099-7897
Phone
(405) 949-8600
NPI assigned
Dec 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 2821 OK Primary

Addresses

Primary practice location

709 N Czech Hall Rd
Yukon, OK 73099-7897

Mailing address

3108 NW 184TH St
Edmond, OK 73012-9650

Other identifiers 2

IdentifierTypeStateIssuer
1149304OtherNCCPA
PA2821OtherOKOKLAHOMA STATE MEDICAL BOARD OF LICENSURE AND SUPERVISION

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190128000375 OK Practitioner - Physician Assistant 2365789500 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

3025 SW 104TH St
Ou HLTH ER and UC Sokc
Oklahoma City, OK 73159-7036
Phone (405) 300-7740

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2821OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince May 9, 2023 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 16, 2019 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 16, 2019 Accepting new patients
Core Primary Care Partners LLC CurrentSince Jan 1, 2026 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

100 NE 85th St
Oklahoma City, OK 73114
Phone (405) 431-9921

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1326553256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 NW 184TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N CZECH HALL RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997897",
            "telephone_number": "405-949-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSHOT",
        "first_name": "CHESTER",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MHA,MHS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-14",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1149304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE MEDICAL BOARD OF LICENSURE AND SUPERVISION",
            "identifier": "PA2821",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.