NPIMap

Individual provider Active NPI

Brent Alan Wakefield, MD

  • Family Medicine Physician
  • Jenks, OK
National Provider Identifier
1447334206
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22988 Issued in OK
Practice address
615 E Main St
Jenks, OK 74037-4138
Phone
(918) 299-8080
Fax
(918) 298-2838
NPI assigned
Oct 25, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22988 OK Primary

Addresses

Primary practice location

615 E Main St
Jenks, OK 74037-4138

Mailing address

615 E Main St
Jenks, OK 74037-4138
Phone (918) 299-8080

Other identifiers 2

IdentifierTypeStateIssuer
7837678OtherOKAETNA
441911615001OtherOKBLUECROSS BLUESHIELD

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
I20050524001384 OK Practitioner - Family Practice 5698714186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lewis and Wakefield PLLCGroup PAC ID 8729020367, 3 clinicians

Practice addresses (Care Compare)

615 E Main St
Jenks Family Physicians
Jenks, OK 74037-4138
Phone (918) 299-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
67.78
Improvement activities
40
Cost
72.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22988OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis & Wakefield, PLLC Family Medicine CurrentSince Jul 18, 2005 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
PF Southern Hills SNF Ops, LLC Past Accepting new patients

Locations

615 E Main St
Jenks, OK 74037
Phone (918) 248-7190

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1447334206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740374138",
            "telephone_number": "918-299-8080",
            "fax_number": "918-298-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740374138",
            "telephone_number": "918-299-8080",
            "fax_number": "918-298-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "BRENT",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "22988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7837678",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "441911615001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenks, OK

Sources for this page

Verify at the official NPI Registry.