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MR. JORDAN ANTONIO VALENZUELA
NPI 1679317028
Student in an Organized Health Care Education/Training Program in Tulsa, OK

Active since June 20, 2024PECOS Enrolled
1111 W 17TH ST, TULSA, OK 74107(918) 582-1972 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jordan Antonio Valenzuela NPPES

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

MR. JORDAN ANTONIO VALENZUELA (NPI 1679317028) is an individual student in an organized health care education/training program in Tulsa, Oklahoma and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679317028
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. JORDAN ANTONIO VALENZUELA
Location Address1111 W 17TH STTulsa, OK 74107-1886
Mailing Address2537 S Harvard Pl Unit 15dTulsa, OK 74114-4636 · (580) 791-2904
Phone(918) 582-1972
Sole ProprietorYes
Enumeration DateJune 20, 2024
NPPES CertifiedJune 20, 2024
✔ NPI 1679317028 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
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jordan Antonio Valenzuela is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Jordan Valenzuela's NPI number?

The NPI number for Jordan Valenzuela is 1679317028. It was assigned to this individual provider in the NPPES registry on June 20, 2024.

Where is Jordan Valenzuela located?

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

What is Jordan Valenzuela's specialty?

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

Is Jordan Valenzuela enrolled in Medicare?

Yes. Jordan Valenzuela is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Valenzuela was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.