Active NPI
Lynda Dianne Bentley, PA
- Physician Assistant
- Cheyenne, OK
National Provider Identifier
1720003189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA912
- Practice address
- 101 FK Buster Ave
Cheyenne, OK 73628 - Phone
- (580) 497-3333
- Fax
- (580) 497-2778
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA912 | OK | Primary |
Addresses
Primary practice location
101 FK Buster Ave
Cheyenne, OK 73628
Mailing address
PO Box 490
Cheyenne, OK 73628-0490
Phone (580) 497-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100161610A | Medicaid | OK |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100504000146 | OK | Practitioner - Physician Assistant | 2062540552 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA912 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integris Cardiovascular Physicians LLC | Past | Accepting new patients | |
| Roger Mills County Hospital Authority | Past | Accepting new patients | |
| Roger Mills County Hospital Authority | 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.
-
- Rural Health Clinic/Center
- Cheyenne, OK
- NPI 1407950447
-
- Critical Access Hospital
- Cheyenne, OK
- NPI 1497857437
-
- Cardiovascular Disease Physician
- Oklahoma City, OK
- NPI 1306129598
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Roger Mills County Hospital Authority
Practice addresses (Care Compare)
501 S LL Males
Cheyenne, OK 73628
Phone (580) 497-3336
P O Box
Suite 490
Cheyenne, OK 73628-0490
Hospital & facility affiliations
- Roger Mills Memorial Hospital
- Great Plains Regional Medical Center
- O U Medical Center
- Weatherford Regional Hospital, Inc of Weatherford
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1720003189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 490",
"city": "CHEYENNE",
"state": "OK",
"postal_code": "736280490",
"telephone_number": "580-497-3333",
"fax_number": "580-497-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 FK BUSTER AVE",
"city": "CHEYENNE",
"state": "OK",
"postal_code": "73628",
"telephone_number": "580-497-3333",
"fax_number": "580-497-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "LYNDA",
"middle_name": "DIANNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "PA912",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100161610A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.