NPIMap

Individual provider Active NPI

Lynda Dianne Bentley, PA

  • Physician Assistant
  • Cheyenne, OK
National Provider Identifier
1720003189
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA912 Issued in OK
Practice address
101 FK Buster Ave
Cheyenne, OK 73628
Phone
(580) 497-3333
Fax
(580) 497-2778
NPI assigned
Jul 13, 2006
Last updated
Apr 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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 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

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
I20100504000146 OK Practitioner - Physician Assistant 2062540552 Reassigns benefits to 1 organization

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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA912OKMDPhysician Assistant

Practice roles

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

Hospital & facility affiliations 8

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": "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, OK

Sources for this page

Verify at the official NPI Registry.