Jacob C. Brown, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2738 Issued in OK

Practice address

5300 SE 29TH St
Del City, OK 73115-4702

Phone

(405) 835-2770

NPI assigned

Mar 28, 2017

Last updated

Mar 28, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PsychplusGroup PAC ID 9234547548, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020
• Mercy Hospital Healdton, Inc. Hospital, Healdton, OK, CCN 371310

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Psychplus

  • Psychiatry Physician
  • Oklahoma City, OK
  • NPI 1215516950
  Medicare reassignment Care Compare group
• Board of Regents of the University of Oklahoma - Ou Physicians

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1801869250
  Medicare reassignment NPD
• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment NPD
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment NPD
• Mercy Hospital Kingfisher, Inc

  • Diagnostic Radiology Physician
  • Kingfisher, OK
  • NPI 1285064618
  Medicare reassignment NPD
• Mercy Hospital Tishomingo, Inc

  • Emergency Medicine Physician
  • Tishomingo, OK
  • NPI 1972809002
  Medicare reassignment NPD
• Mercy Hospital Tishomingo, Inc.

  dba Mercy Hospital Tishomingo

  • Critical Access Hospital
  • Tishomingo, OK
  • NPI 1932404431
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment
• Creek Nation Hospital & Clinics

  dba Creek Nation Community Hospital

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment
• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment
• Emergency Physicians of Midwest City, LLC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1558386474
  Medicare reassignment
• Medical Resource Management, LLC

  dba Access Medical Center

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1104056365
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  dba Mercy Hospital Ada

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation
• Mercy Hospital Healdton, Inc.

  • Critical Access Hospital
  • Healdton, OK
  • NPI 1578710406
  Care Compare affiliation

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1972035145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SE 51ST ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731354202",
            "telephone_number": "479-966-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 SE 29TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731154702",
            "telephone_number": "405-835-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA2738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew J Boeckman, MD
• Breanna Eviemarie Boor, DDS
• Mackenzie Alexis Boyle
• Shane Palmer Braig
• Melanie Elaine Broadway
• Trendolyn Brown
• Carl Bryant
• Carmen Delores Butler
• Brooklyn Byrd
• James Thomas Cail III, D.O.

• Physician Assistant in Del City, OK
• Providers in Del City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.