MATTIE LETHERMON (AGACNP-BC) – Acute Care Nurse Practitioner, NPI 1740063577
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,299 NURSE PRACTITIONER in OK
Provider Addresses for MATTIE LETHERMON (AGACNP-BC)
4937 S QUINCY AVE
TULSA, OK 741054730
Phone: (620) 515-4814
Type: Mailing
1220 N FLORENCE AVE
CLAREMORE, OK 740174381
Phone: (918) 341-5311
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $133.
Total Amount is formed as General ($133) + Research ($0) + Ownership ($0) = $133.
Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Lexicon Pharmaceuticals, Inc. ($115).
Total Amount
$133
General + Research + Ownership
Payments
2
Total payment records
General Amount
$133
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lexicon Pharmaceuticals, Inc. | $115 |
| Solventum Corporation | $18 |
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: 2024-02-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20231024002967 | I | Nurse Practitioner | OK | TBD |
| I20240213002328 | I | Nurse Practitioner | TX | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| - | OK | |
| - | OK | |
| Emergency Medicine | SC | |
| - | OK | |
| Family Practice | OK | |
| - | OK | |
| - | OK | |
| Internal Medicine, Hospice/Palliative Care | OK | |
| Emergency Medicine | OK |
Reviews
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