NPIMap

Individual provider Active NPI

Jeffrey Don Bivens, P.A.-C

  • Medical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1861565533
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA807 Issued in OK
Practice address
225 NE 97TH St
Suite 600
Oklahoma City, OK 73114-6302
Phone
(405) 841-7875
NPI assigned
Nov 17, 2006
Last updated
Sep 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA807 OK Primary

Addresses

Primary practice location

225 NE 97TH St
Suite 600
Oklahoma City, OK 73114-6302

Mailing address

14275 Midway Road
Suite 400
Addison, TX 75001-3676
Phone (405) 841-7875

Other identifiers 1

IdentifierTypeStateIssuer
100156320AMedicaidOK

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
I20040607000530 OK Practitioner - Physician Assistant 4082696653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 842-2061

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7251

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
807OKMDOccupational Therapy Assistant
PA807OKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Services, Inc. CurrentSince May 30, 2016 Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients
Urology Associates of North Texas LLP Past Accepting new patients
Southwest Orthopaedic Specialists, P.L.L.C. Past Accepting new patients

Locations

225 NE 97th St
Oklahoma City, OK 73114
Phone (405) 608-6100

225 NE 97th St
#600
Oklahoma City, OK 73114
Phone (405) 841-7875

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1861565533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY ROAD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013676",
            "telephone_number": "405-841-7875",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NE 97TH ST",
            "address_2": "SUITE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146302",
            "telephone_number": "405-841-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVENS",
        "first_name": "JEFFREY",
        "middle_name": "DON",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100156320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.