Individual provider Active NPI

Jessica Lynn Montesano, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1528096807
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3517 Issued in KS
Practice address
9104 E 62ND St
Tulsa, OK 74133-6443
Phone
(918) 461-9490
Fax
(918) 461-9690
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3517 KS Primary

Addresses

Primary practice location

9104 E 62ND St
Tulsa, OK 74133-6443

Mailing address

9104 E 62ND St
Tulsa, OK 74133-6443
Phone (918) 461-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000373 OK Practitioner - Chiropractic 5698941656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Wise Chiropractic Inc PCGroup PAC ID 3678629805, 2 clinicians

Practice addresses (Care Compare)

9104 E 62ND St
Tulsa, OK 74133-6443
Phone (918) 461-9490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3517KSMDChiropractor
3517OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Wise Chiropractic Inc PC Chiropractor CurrentSince Jun 1, 2000 Accepting new patients

Locations

9104 E 62nd St
Tulsa, OK 74133
Phone (918) 461-9490

8421 E 61st St
Ste T
Tulsa, OK 74133

Organizations & group practices 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1528096807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 E 62ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336443",
            "telephone_number": "918-461-9490",
            "fax_number": "918-461-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 E 62ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336443",
            "telephone_number": "918-461-9490",
            "fax_number": "918-461-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTESANO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.