Individual provider Active NPI

Nathan Boyd White, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1336539436
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2422 Issued in OK
Practice address
6475 S Yale Ave Ste 301
Tulsa, OK 74136
Phone
(918) 494-9300
Fax
(918) 494-9355
NPI assigned
Jan 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2422 OK Primary
Surgical Physician Assistant 363AS0400X 2422 OK

Addresses

Primary practice location

6475 S Yale Ave Ste 301
Tulsa, OK 74136

Mailing address

6475 S Yale Ave Ste 301
Tulsa, OK 74136-7815
Phone (918) 494-9341

Other identifiers 1

IdentifierTypeStateIssuer
200572790AMedicaidOK

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
I20150217001532 OK Practitioner - Physician Assistant 9638494594 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Regional Providers Primary CareGroup PAC ID 5496837718, 56 clinicians
NRHS Radiology AssociatesGroup PAC ID 2668555731, 61 clinicians

Practice addresses (Care Compare)

2000 Ann Branden Blvd
FL 2
Norman, OK 73071-1667
Phone (405) 515-0520

2247 S Delaware PL
Justin L McCoy MD
Tulsa, OK 74114-3110
Phone (405) 307-1600

2605 SW 119TH St a
Primary Care
Oklahoma City, OK 73170-2601
Phone (405) 912-3400

2605 SW 119TH St B
Chiropractic and Wellness Clinic
Oklahoma City, OK 73170-2601
Phone (405) 912-3900

3300 Healthplex Pkwy
Norman, OK 73072-9749
Phone (405) 515-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
88.72
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince May 7, 2018 Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 6

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1336539436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 S YALE AVE STE 301",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367815",
            "telephone_number": "918-494-9341",
            "fax_number": "918-494-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 S YALE AVE STE 301",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-494-9300",
            "fax_number": "918-494-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NATHAN",
        "middle_name": "BOYD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-27",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2422",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "2422",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200572790A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.