Individual provider Active NPI

Jesse Hart, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1962707372
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1972 Issued in OK
Practice address
3400 NW Expressway
Suite 200
Oklahoma City, OK 73112-4493
Phone
(405) 713-9900
Fax
(405) 713-9920
NPI assigned
Jan 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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 1972 OK Primary

Addresses

Primary practice location

3400 NW Expressway
Suite 200
Oklahoma City, OK 73112-4493

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 713-9900

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
I20110304000712 OK Practitioner - Physician Assistant 9830371384 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County, Inc CurrentSince Aug 13, 2018 Accepting new patients
Classen Urgent Care Clinic LLC CurrentSince Jul 1, 2018 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Aug 13, 2018 Accepting new patients
Aky MD, LLC Past Accepting new patients

Locations

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

2818 Classen Blvd
Norman, OK 73071
Phone (405) 701-7111

Interoperability endpoints

  • Direct secure messaging: jhart989813@directc.mercy.net
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.973232
  • Direct secure messaging: jhart@jkp.gwaydirect.com
  • FHIR API: https://fhir.meditouchehr.com/api/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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1962707372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-9900",
            "fax_number": "405-713-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124493",
            "telephone_number": "405-713-9900",
            "fax_number": "405-713-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JESSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-14",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.