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JACY D DONNELLY DO
NPI 1457937138
Psychiatry & Neurology - Psychiatry in Broken Arrow, OK

Active since March 22, 2021PECOS EnrolledAccepts Medicare Assignment
512 W ATLANTA ST, BROKEN ARROW, OK 74012(918) 370-4461(918) 512-4723 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 4, 2025, Jul 11, 2022, Mar 22, 2021 (3 updates tracked since 2021).

About Jacy D Donnelly Do NPPES

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

JACY D DONNELLY DO (NPI 1457937138) is an individual psychiatry provider in Broken Arrow, Oklahoma, licensed in Oklahoma (7721) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1457937138
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameJACY D DONNELLYCredential: DO
Location Address512 W ATLANTA STBroken Arrow, OK 74012-7004
Mailing Address5310 E 31st St Ste LlTulsa, OK 74135-5018 · (918) 236-4000 · Fax (918) 236-4001
Phone(918) 370-4461
Fax(918) 512-4723
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 22, 2021
Last NPPES UpdateJuly 4, 20253 updates tracked since enumeration
NPPES CertifiedJuly 4, 2025
✔ NPI 1457937138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in OK · 7721
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
512 W ATLANTA ST, Broken Arrow, OK 74012
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Medica, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacy D Donnelly Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345745956
PECOS Enrollment IDI20250924004702
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$162.61 typical visit price
range $53.00 – $162.61
Typical copayment $40.65 (range $13.25 – $40.65)
Most-billed visit code 99205
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

KATHERINE SILVEY BATES MCMHC
Counselor
512 W ATLANTA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 615-6620
NURIAN CLAY CABALLERO
Case Management
512 W ATLANTA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 280-9104
ROBERT HOGG DO PLLC
Psychiatry & Neurology (Psychiatry)
512 W ATLANTA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 370-4461

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 Jacy Donnelly's NPI number?

The NPI number for Jacy Donnelly is 1457937138. It was assigned to this individual provider in the NPPES registry on March 22, 2021.

Where is Jacy Donnelly located?

Jacy Donnelly practices at 512 W Atlanta St, Broken Arrow, OK 74012. The listed phone number is (918) 370-4461.

What is Jacy Donnelly's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Jacy Donnelly enrolled in Medicare?

Yes. Jacy Donnelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacy Donnelly accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, Medica, Oscar Insurance Company and UnitedHealthcare list Jacy Donnelly 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 Jacy Donnelly was last updated on July 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.