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JIM AGEI ENOH
NPI 1114640091
Student in an Organized Health Care Education/Training Program in Tulsa, OK

Active since September 26, 2022PECOS Enrolled
1111 W 17TH ST, TULSA, OK 74107(918) 582-1972 Get Directions Write a Review

NPPES record last updated: September 26, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jim Agei Enoh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIM AGEI ENOH (NPI 1114640091) is an individual student in an organized health care education/training program in Tulsa, Oklahoma and active in the NPI registry since September 2022. He is enrolled in Medicare PECOS and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2024).

NPPES Registry Identity

NPI1114640091
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJIM AGEI ENOH
Location Address1111 W 17TH STTulsa, OK 74107
Mailing Address2030 S Maybelle AveTulsa, OK 74107-1832
Phone(918) 582-1972
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2024
Enumeration DateSeptember 26, 2022
NPPES CertifiedSeptember 25, 2022
✔ NPI 1114640091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1111 W 17TH ST, Tulsa, OK 74107
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jim Agei Enoh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204314495
PECOS Enrollment IDI20260129002163
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jim Enoh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Creoks Mental Health Services
5.3 mi
Family Medicine
4103 S YALE AVE STE C
Tulsa, OK 74135
  • Reassigned Medicare billing, Oklahoma enrollment
  • 77 clinicians in this Medicare group
NPI 1710583372 (918) 495-4110
Tasel Health LLC
100 mi
Psychiatry
9210 S WESTERN AVE STE A-21
Oklahoma City, OK 73139
  • Reassigned Medicare billing, Oklahoma enrollment
  • 3 clinicians in this Medicare group
NPI 1851035398 (405) 934-1681

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAHAM NATHAN JAMEISON MAT, ATC
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 237-2828
MARIYA BOBEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KARLYN TANZEY
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KAYLEY ANTHAMATTEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
CHASE YAGER
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (405) 613-1540
MACKENZIE LYNN HATTABAUGH
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
ASHLEE EASTMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 805-1752
DAVID ROBERT WAXMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jim Enoh's NPI number?

The NPI number for Jim Enoh is 1114640091. It was assigned to this individual provider in the NPPES registry on September 26, 2022.

Where is Jim Enoh located?

Jim Enoh practices at 1111 W 17th St, Tulsa, OK 74107. The listed phone number is (918) 582-1972.

What is Jim Enoh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jim Enoh enrolled in Medicare?

Yes. Jim Enoh is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jim Enoh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jim Enoh reassigns Medicare benefits to 2 organizations: Creoks Mental Health Services (Tulsa, OK) and Tasel Health LLC (Oklahoma City, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jim Enoh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jim Enoh accept?

Health plans from Oscar Insurance Company list Jim Enoh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jim Enoh was last updated on September 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.