JETTA ANGE (PA-C) – Physician Assistant, NPI 1336686492
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,810 PHYSICIAN ASSISTANT in OK
Provider Addresses for JETTA ANGE (PA-C)
334, Brownfield Road, South Hiram, Porter, Oxford County, Maine, 04068, United States
PORTER, OK 744540334
Phone: (918) 483-0111
Fax: (918) 483-4174
Type: Mailing
702 NW SHERIDAN RD
LAWTON, OK 735055203
Phone: (580) 576-3376
Fax: (580) 576-3375
Type: Mailing
4920 SW LEE BLVD
LAWTON, OK 735058339
Phone: (580) 536-8844
Fax: (580) 536-8818
Type: Mailing
619, North Main Street, Muskogee, Muskogee County, Oklahoma, 74401, United States
BUILDING D
MUSKOGEE, OK 744014431
Phone: (918) 682-0222
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 46 Open Payments records for all available years, with a total value of $998.
Total Amount is formed as General ($998) + Research ($0) + Ownership ($0) = $998.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: GENZYME CORPORATION ($440).
Total Amount
$998
General + Research + Ownership
Payments
46
Total payment records
General Amount
$998
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GENZYME CORPORATION | $440 |
| Regeneron Healthcare Solutions, Inc. | $269 |
| Optinose US, Inc. | $154 |
| GlaxoSmithKline, LLC. | $73 |
| Phathom Pharmaceuticals, Inc. | $30 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-03-14
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170314001779 | I | Physician Assistant | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 86003 | Measurement of antibody (ige) to allergic substance, crude allergen extract, each | 944 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 530 | 287 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 340 | 15 | $0 |
| 95115 | Professional service for single injection of allergen | 228 | 22 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 167 | 116 | $0 |
Insurance plans in this area (ZIP 74454)
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