Individual provider Active NPI

Dona Robertson, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1366867947
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2369 Issued in OK
Practice address
9716 Riverside Pkwy
Tulsa, OK 74137-7447
Phone
(918) 528-6156
NPI assigned
Feb 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 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 2369 OK Primary

Addresses

Primary practice location

9716 Riverside Pkwy
Tulsa, OK 74137-7447

Mailing address

9716 Riverside Pkwy
Tulsa, OK 74137-7447

Other practice location 1

9917 SE 15th St
Oklahoma City, OK 73130-5504
Phone (405) 622-2078

Other practice location 2

1400 SE 4th St
ste h
Moore, OK 73160-7329
Phone (405) 799-7400

Other identifiers 1

IdentifierTypeStateIssuer
2369OtherOKOK MEDICAL BOARD

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
I20140516001582 OK Practitioner - Physician Assistant 5799908877 Reassigns benefits to 3 organizations
Practice locations: Moore, OK

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillcrest Urgent Care, LLCGroup PAC ID 6608393715, 41 clinicians
Tulsa Emergency Medical Center IncGroup PAC ID 3375442692, 23 clinicians

Practice addresses (Care Compare)

1623 S Utica Ave
Tulsa, OK 74104-4909
Phone (918) 392-5100

2929 S Garnett Rd
Tulsa, OK 74129-5101
Phone (918) 665-1520

9716 Riverside Pkwy
Suite 100
Tulsa, OK 74137-7450
Phone (918) 528-4897

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2369OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Primary Care Inc Past Accepting new patients
Oca MWC LP Past Accepting new patients
Revive Health of Oklahoma LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dona.robertsonpac.p8@direct.nextcare.nextgenshare.com
  • Direct secure messaging: dona.robertsonpac.p10@direct.nextcare.nextgenshare.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1366867947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9716 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9716 RIVERSIDE PKWY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377447",
            "telephone_number": "918-528-6156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9917 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731305504",
            "country_code": "US",
            "telephone_number": "405-622-2078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 SE 4th St",
            "address_2": "ste h",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "OK",
            "postal_code": "731607329",
            "country_code": "US",
            "telephone_number": "405-799-7400",
            "fax_number": "405-799-7405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "DONA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK MEDICAL BOARD",
            "identifier": "2369",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.