JACK BRADLEY SMITH (PA) – Physician Assistant, NPI 1528036704
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for JACK BRADLEY SMITH (PA)
3400 S Douglas Blvd
Oklahoma City, OK 731501001
Phone: (405) 815-5600
Type: Location
13401 N Western Ave
Oklahoma City, OK 731141408
Phone: (405) 252-3400
Type: Location
5200 E I 240 Service Rd
Oklahoma City, OK 731352607
Phone: (405) 628-6000
Type: Location
700 NE 13th St
Oklahoma City, OK 731045004
Phone: (405) 271-5321
Type: Location
4050 W Memorial Rd
Oklahoma City, OK 731208382
Phone: (405) 608-3800
Type: Location
13500 S Tulsa Dr
Oklahoma City, OK 731709719
Phone: (405) 815-5600
Type: Location
201 S Sara Rd
Mustang, OK 730644306
Phone: (405) 376-4505
Type: Location
2115 Parkview Drive
El Reno, OK 730360000
Phone: (405) 262-2640
Type: Location
1000 N Lee Ave
Oklahoma City, OK 731021036
Phone: (405) 272-7000
Type: Location
West Memorial Road, Oklahoma City, Oklahoma County, Oklahoma, 73142, United States
OKLAHOMA CITY, OK 731341785
Phone: (405) 751-4664
Fax: (405) 749-4561
Type: Location
18432 WILD HORSE TRL
NORMAN, OK 730729603
Phone: (405) 760-0560
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2004-03-25
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20040325000815 | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 66 | 64 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 49 | 48 | $0 |
Insurance plans in this area (ZIP 73150)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | OK | |
| Physician Assistant | UT | |
| General Practice, Family Practice | OK | |
| Nurse Practitioner | MO |
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