NPIMap

Individual provider Active NPI

Crystal A Mahana, PA-C

  • Physician Assistant
  • Prague, OK
National Provider Identifier
1356811558
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2955 Issued in OK
Practice address
1322 Klabzuba Ave
Prague, OK 74864-4900
Phone
(405) 567-4922
NPI assigned
Nov 29, 2018
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 2955 OK Primary

Addresses

Primary practice location

1322 Klabzuba Ave
Prague, OK 74864-4900

Mailing address

2732 NW 155TH St
Edmond, OK 73013-8812
Phone (409) 434-8257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123003056 OK Practitioner - Physician Assistant 7416294830 Reassigns benefits to 19 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians
Prague Healthcare AuthorityGroup PAC ID 8123435187, shared by 4 NPIs, 12 clinicians
Cah Acquisition Company 9 LLCGroup PAC ID 0941354823, 15 clinicians

Practice addresses (Care Compare)

1121 NW 63Rd St
Suite 5001
Nichols Hills, OK 73116-6504
Phone (405) 652-0632

1322 Klabzuba Ave
Prague, OK 74864-4900
Phone (405) 567-4922

1380 W Covell Rd
132 Mercy Gohealth Urgent Care N Edmond
Edmond, OK 73003-3575
Phone (405) 279-9637

809 NE Hwy 60
Seiling, OK 73663

809 NE Hwy 60
Seiling, OK 73663-2705
Phone (580) 377-1005

PO Box
Suite 1043
Seiling, OK 73663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2955OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Oklahoma, Inc. CurrentSince Jul 9, 2023 Accepting new patients
Seiling Municipal Hospital Authority CurrentSince Dec 1, 2024 Accepting new patients
Cordell Memorial Hospital 0189 CurrentSince Mar 26, 2024 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jun 28, 2021 Accepting new patients
Kiowa County Hospital Authority CurrentSince Jun 23, 2025 Accepting new patients
Community Hospital LLC Physician Assistant CurrentSince Apr 25, 2022 Accepting new patients
Seiling Municipal Hospital Authority Current Accepting new patients
Cordell Memorial Hospital 0189 CurrentSince Mar 26, 2024 Accepting new patients
Prague Healthcare Authority CurrentSince Dec 1, 2022 Accepting new patients
Prague Healthcare Authority CurrentSince Dec 1, 2022 Accepting new patients
Clinton Hospital Authority CurrentSince Jun 1, 2024 Accepting new patients
Cordell Memorial Hospital 0189 Past Accepting new patients
Cah Acquisition Company 9, LLC Past Accepting new patients

Locations

100 N 30th St
Clinton, OK 73601
Phone (580) 323-2363

1220 N Glenn L English St
Cordell, OK 73632
Phone (580) 832-3339

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

429 W Elm St
Hobart, OK 73651
Phone (580) 726-1900

3100 SW 89th St
Oklahoma City, OK 73159
Phone (405) 602-8100

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

1322 Klabzuba Ave
Prague, OK 74864
Phone (405) 567-2295

809 NE Highway 60
Seiling, OK 73663
Phone (580) 377-1005

Interoperability endpoints

  • Direct secure messaging: cmahana506675@direct-ehr-ssmhc.com

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 6

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": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1356811558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 NW 155TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138812",
            "telephone_number": "409-434-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 KLABZUBA AVE",
            "city": "PRAGUE",
            "state": "OK",
            "postal_code": "748644900",
            "telephone_number": "405-567-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHANA",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prague, OK

Sources for this page

Verify at the official NPI Registry.