JENTRY MCBROOM (PA) – Physician Assistant, NPI 1801778337

JENTRY MCBROOM (PA) is a healthcare provider. based in Idabel, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5486 (OK). The NPI Number for JENTRY MCBROOM (PA) is 1801778337

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
JENTRY MCBROOM (PA)
NPI
1801778337
Phone
(580) 286-2600
Address
902 E LINCOLN RD
Enumeration Date
24 July 2025
Last Update Date
24 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185677000
Graduation Year
2025 (1 year ago)
PAC ID
3173028917
Group Practice PAC ID
1759294838
Professional Enrollment ID
I20250924000354
Address ID
OK747457817ID902XXRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

1,797 PHYSICIAN ASSISTANT in OK

Provider Addresses for JENTRY MCBROOM (PA)

  • 902 E LINCOLN RD

    IDABEL, OK 747457337

    Phone: (580) 286-2600

    Mailing address matches the actual address.

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: 2025-09-24

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250924000354IPhysician AssistantTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 74745)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759294838View full group profile
NameSpecialtyState
-TX
-OK
Diagnostic RadiologyOK
Nurse PractitionerOK
N E U R O L O G YAR
E N D O C R I N O L O G YAR
Mental Health CounselorOK
O P T O M E T R YOK
-OK
Interventional Radiology, Diagnostic Radiology, Diagnostic RadiologyOK

Reviews

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Frequently asked questions

What NPI should I save for JENTRY MCBROOM (PA)?
Save NPI 1801778337 if you need a stable reference for JENTRY MCBROOM (PA).
Is JENTRY MCBROOM (PA)'s NPI currently valid?
The extract we use shows JENTRY MCBROOM (PA) as active.
What does JENTRY MCBROOM (PA) treat or focus on?
Patients typically see JENTRY MCBROOM (PA) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Does JENTRY MCBROOM (PA) practice in Oklahoma?
You will see Idabel, Oklahoma on file for JENTRY MCBROOM (PA) alongside any extra practice locations.
How can I contact JENTRY MCBROOM (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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