Michael G Jenson, PAC CPP

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

538 Issued in OK

Practice address

6585 South Yale
Suite 1110
Tulsa, OK 74136

Phone

(918) 502-7246

Fax

(918) 502-7250

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Elite Footcare Center PC

  • Foot & Ankle Surgery Podiatrist
  • Tulsa, OK
  • NPI 1861642654
  NPD (past)
• Hatton Anesthesia LLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1659922201
  NPD (past)
• Pain Care Associates of Oklahoma

  • Interventional Pain Medicine Physician
  • Tulsa, OK
  • NPI 1073600714
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1770684540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 E 91ST ST",
            "address_2": "LB003",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372841",
            "telephone_number": "918-502-7246",
            "fax_number": "918-502-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 SOUTH YALE",
            "address_2": "SUITE 1110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-502-7246",
            "fax_number": "918-502-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PAC CPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA8285",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070240A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680535868002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Lynn Jensen, APRN
• Eric Andrew Jensen, CRNA
• Madison Jensen, LMSW U/S
• Mary Ellen Jensen, MD
• Megan Caroline Jensen
• Daniel J Jeremiah-Tang, DO
• Bryan F Jernigan II, CRNA
• Duie R Jernigan, PH.D.
• Jerome Holmes
• Colby Ralph Jerome

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.