Jacklyn Papa, DO
Individual provider Active NPI Internal Medicine Physician · Oklahoma City, OK
NPI 1922595370 · NPPES record last updated Aug 26, 2021
Key facts
- NPI
- 1922595370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 7262 (OK)
- Practice address
- 4300 W Memorial Rd
Oklahoma City, OK 73120-8304 - Phone
- (405) 752-3962
- Fax
- (405) 752-3963
- NPI assigned
- Apr 20, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Oklahoma Communities
Practice addresses (Care Compare)
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515
Hospital & facility affiliations
- Mercy Hospice
- Mercy Hospital Oklahoma City, Inc
- Mercy Hospital Ardmore, Inc
- Oklahoma Heart Hospital, LLC
- Oklahoma Heart Hospital South, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210902002218 | OK | Practitioner - Internal Medicine | 4183020928 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7262 | OK | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Oklahoma Communities | Internal Medicine | Current |
Accepting new patients |
| Mercy Hospital Oklahoma City, Inc | Past | Accepting new patients |
Locations
4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962
4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 7262 | OK | Yes |
Addresses
Primary practice location
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Mailing address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 752-3962
Other providers in Oklahoma City, OK
- Maurene E Pantaleano
- Ella Pantalone
- Joana Cecilia Pantoja
- Lucely Pantoja
- Luis Alberto Pantoja
- Nicole Sarah Papac
- Roshin Augustine Papaly
- Randall Ashley Pape
- Adrian Pappan
- Juanita Pappas
All providers in Oklahoma City, OK · Internal Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.