LARRY RAY TEVEBAUGH JR. NURSE PRACTITIONER
NPI 1619560984
Nurse Practitioner in Yukon, OK

Q: What is Larry Tevebaugh's NPI number?

The NPI number for Larry Tevebaugh is 1619560984. It was assigned to this individual provider in the NPPES registry on February 17, 2021.

Q: What is Larry Tevebaugh's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Larry Tevebaugh was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since February 17, 2021PECOS EnrolledAccepts Medicare Assignment

4400 GRANT BLVD, YUKON, OK 73099(405) 830-5574 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2026, Feb 26, 2021, Feb 17, 2021 (3 updates tracked since 2021).

On this page

About Larry Ray Tevebaugh Jr. Nurse Practitioner NPPES

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

LARRY RAY TEVEBAUGH JR. NURSE PRACTITIONER (NPI 1619560984) is an individual nurse practitioner in Yukon, Oklahoma, licensed in Oklahoma (1619560984) and active in the NPI registry since February 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1619560984

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameLARRY RAY TEVEBAUGH JR.Credential: NURSE PRACTITIONER

Location Address4400 GRANT BLVDYukon, OK 73099-0037

Mailing Address4400 Grant BlvdYukon, OK 73099-0037 · (405) 787-8550

Phone(405) 830-5574

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 17, 2021

Last NPPES UpdateMay 11, 20263 updates tracked since enumeration

NPPES CertifiedMay 11, 2026

✔ NPI 1619560984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in OK · 1619560984

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License R0094181 (OK)

4400 GRANT BLVD, Yukon, OK 73099

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Medica, Mending Health 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

Larry Ray Tevebaugh Jr. Nurse Practitioner 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 ID5092158600

PECOS Enrollment IDI20240212001228

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

132 services104 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

125 services69 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73099 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

Most-billed visit code 99214

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 10

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

TOTAL OPTICAL LLC

Ophthalmology

4400 GRANT BLVD, SUITE 106
YUKON, OK 73099

Canadian County (405) 603-4744

JACINDA HANTAK APRN-CNP

Nurse Practitioner (Family)