Individual provider Active NPI

Michael Jerome Iten, P.A.

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1851359947
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2274 Issued in OK
Practice address
6160 S Yale Ave
Tulsa, OK 74136-1930
Phone
(918) 495-2600
Fax
(918) 497-3007
NPI assigned
May 1, 2006
Last updated
May 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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 2274 OK Primary

Addresses

Primary practice location

6160 S Yale Ave
Tulsa, OK 74136-1930

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125

Other practice location 1

10506 S Memorial Dr
Tulsa, OK 74133-6914
Phone (918) 943-1050

Other identifiers 1

IdentifierTypeStateIssuer
200499900AMedicaidOK

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
I20131231001120 OK Practitioner - Physician Assistant 8628206323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2274OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Dec 1, 2013 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

700 W 7th Ave
Bristow, OK 74010
Phone (918) 367-2215

11610 N 137th East Ave
Collinsville, OK 74021
Phone (918) 272-2247

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

10506 S Memorial Dr
Tulsa, OK 74133
Phone (918) 369-3200

6160 S Yale Ave
Tulsa, OK 74136
Phone (918) 492-7200

6160 S Yale Ave
Fl 1
Tulsa, OK 74136
Phone (918) 495-2600

6475 S Yale Ave
Ste 200
Tulsa, OK 74136
Phone (918) 494-4400

6475 S Yale Ave
Ste 202
Tulsa, OK 74136
Phone (918) 494-4460

6600 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-1805

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: miten9433@direct.saintfrancis.com

Organizations & group practices 3

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 3

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1851359947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0125",
            "fax_number": "918-502-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361930",
            "telephone_number": "918-495-2600",
            "fax_number": "918-497-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10506 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741336914",
            "country_code": "US",
            "telephone_number": "918-943-1050",
            "fax_number": "918-369-3209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITEN",
        "first_name": "MICHAEL",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200499900A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.