Individual provider Active NPI

Kaci Brooke Juengel, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1679030738
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2985 Issued in OK
Practice address
3301 NW 50TH St Ste 100
Oklahoma City, OK 73112-5708
Phone
(405) 947-0911
Fax
(405) 947-1341
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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 2985 OK Primary

Addresses

Primary practice location

3301 NW 50TH St Ste 100
Oklahoma City, OK 73112-5708

Mailing address

3301 NW 50TH St Ste 100
Oklahoma City, OK 73112-5708
Phone (405) 947-0911

Other names 1

  • Kaci Brooke Reeves Former name

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
I20190611002115 OK Practitioner - Physician Assistant 6406189232 Reassigns benefits to 2 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 Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1679030738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 NW 50TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125708",
            "telephone_number": "405-947-0911",
            "fax_number": "405-947-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 NW 50TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125708",
            "telephone_number": "405-947-0911",
            "fax_number": "405-947-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUENGEL",
        "first_name": "KACI",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACI",
            "last_name": "REEVES",
            "middle_name": "BROOKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.