Individual provider Active NPI

Jeremy M Mason, DPM

  • Podiatrist
  • Owasso, OK
National Provider Identifier
1710154471
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
256 Issued in OK
Practice address
10229 E 96TH St N Suite 101
Owasso, OK 74055
Phone
(918) 272-8920
Fax
(918) 272-8922
NPI assigned
May 13, 2008
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 256 OK Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 00256 OK

Addresses

Primary practice location

10229 E 96TH St N Suite 101
Owasso, OK 74055

Mailing address

701 W. Elgin St
Broken Arrow, OK 74012
Phone (918) 455-2001

Other identifiers 1

IdentifierTypeStateIssuer
00256OtherOKOKLAHOMA LICENSE NUMBER

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080819000230 OK Practitioner - Podiatry 9931274453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma Mobile Podiatry Services LLCGroup PAC ID 4385086206, 2 clinicians

Practice addresses (Care Compare)

10229 E 96TH St N
Suite 100
Owasso, OK 74055-5322
Phone 91849429021007

2300 S Broadway
Suite 110
Edmond, OK 73013-4065
Phone (405) 285-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue121
Removal of skin lesions11
Removal of nail tissue1950
Removal or shaving of skin growth1137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
256OKMDAddiction (Substance Use Disorder) Counselor
00256OKMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Tulsa Foot & Ankle Specialist PLLC Podiatrist CurrentSince Jul 1, 2008 Accepting new patients
Tulsa Podiatry Clinics LLC Podiatrist CurrentSince Apr 21, 2026 Accepting new patients
Oklahoma Mobile Podiatry Services LLC CurrentSince Mar 11, 2024 Accepting new patients
Metro Tulsa Foot & Ankle Specialist PLLC Podiatrist CurrentSince Jul 1, 2008 Accepting new patients

Locations

701 W Elgin St
Broken Arrow, OK 74012
Phone (918) 455-2001

2300 S Broadway
Ste 110
Edmond, OK 73013
Phone (405) 209-0322

10229 E 96th St N
Ste 100
Owasso, OK 74055
Phone (918) 272-8920

10229 E 96th St N
Ste 101
Owasso, OK 74055
Phone (918) 272-8920

5711 E 71st St
Ste 115
Tulsa, OK 74136
Phone (918) 294-3668

5711 E 71st St
Ste 220
Tulsa, OK 74136

Interoperability endpoints

  • Direct secure messaging: jeremy.mason@direct.stjohnhealthsystem.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1710154471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W. ELGIN ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-455-2001",
            "fax_number": "918-301-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10229 E 96TH ST N SUITE 101",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-272-8920",
            "fax_number": "918-272-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "JEREMY",
        "middle_name": "M",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "256",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "00256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA LICENSE NUMBER",
            "identifier": "00256",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.