Nicole Coburn
NPI 1558903369ActiveIndividual· Physician Assistant· Tulsa, OK
Physician Assistant with St. John Physicians, Inc., practicing in Tulsa, Oklahoma. Medicare paid $20,279 for services to 93 patients in 2024. Lists Ascension St John Medical Center as a hospital affiliation.
Overview
| NPI | 1558903369 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Oct 14, 2019 |
| Last updated in NPPES | Apr 3, 2020 |
| Certified by provider | Apr 3, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 3176 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OK) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 93 |
|---|---|
| Services billed | 293 across 6 procedure codes |
| Paid by Medicare | $20,279 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- St. John Physicians, Inc.Tulsa, OK · 259 clinicians
Hospital affiliation
- Ascension St John Medical CenterTulsa, OK
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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