Individual provider Active NPI

Jozeca Oongwak Meyer, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1417549122
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4459 Issued in OK
Practice address
9228 S Mingo Rd Ste 101
Tulsa, OK 74133-5721
Phone
(405) 378-2727
NPI assigned
Feb 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 4459 OK Primary

Addresses

Primary practice location

9228 S Mingo Rd Ste 101
Tulsa, OK 74133-5721

Mailing address

PO Box 707001
Tulsa, OK 74170-7001

Other identifiers 1

IdentifierTypeStateIssuer
200967650AMedicaidOK

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
I20210324000159 OK Practitioner - Physician Assistant 8729495569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
McClure and Associates Psychiatry PLLCGroup PAC ID 6406297415, 6 clinicians

Practice addresses (Care Compare)

6135 S 90TH E Ave
Tulsa, OK 74133-6365
Phone (539) 367-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4459OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
McClure & Associates Psychiatry PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

6135 S 90th East Ave
Tulsa, OK 74133
Phone (539) 367-1145

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jozecameyer@148561.advancedmd-direct.com

Organizations & group practices 2

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": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1417549122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707001",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741707001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD STE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335721",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "JOZECA",
        "middle_name": "OONGWAK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200967650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.