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Jared Scott Ellsworth , PA

Physician Assistant • Ardmore, OK

Active NPI 1821829821 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

1104 Walnut Dr
Ardmore, OK 734012353

Call 5802233411 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1104 Walnut Dr

Ardmore, OK 734012353

Telephone 5802233411
Fax 5802262284
Organization at the Same NPPES Address or Phone
Miguel A. Camacho, Md P.c. Facility NPI 1497862304

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Good Shepherd Community Clinic, Inc.. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2024

Open Payments general payments, program year 2025

All general payments: $344.87 across 16 records.

By nature of payment

  • Food and Beverage: $344.87 across 16 records.

Reporting-company totals (3 largest of 7)

  • Novo Nordisk Inc: $92.57 across 4 records.
  • ABBVIE INC.: $87.30 across 4 records.
  • Eli Lilly and Company: $45.23 across 3 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

Years since graduation

2 years (graduated 2024)

CMS Doctors and Clinicians data list 2024 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Jared Ellsworth has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Jared Ellsworth as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Ardmore and Oklahoma

20 active clinicians are listed under Physician Assistant with a practice address in Ardmore, OK (1,870 in Oklahoma).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Ardmore

15% of these 20 clinicians have the CMS telehealth indicator.

75% of these 20 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): 16 records totaling $344.87.

Manufacturer Payment Nature Product Type Amount ($)
Boston Scientific Corporation
Food and Beverage
In-kind items and services
Intracept General $44.46
ABBVIE INC.
Food and Beverage
In-kind items and services
QULIPTA General $33.20
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Rybelsus General $31.99
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Rybelsus General $24.47
AstraZeneca Pharmaceuticals LP
Food and Beverage
In-kind items and services
BREZTRI General $21.69
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Ozempic General $21.10
Tactile Systems Technology Inc
Food and Beverage
In-kind items and services
Flexitouch Plus General $20.66
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $19.45
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $17.66
ABBVIE INC.
Food and Beverage
In-kind items and services
VRAYLAR General $16.99
Pfizer Inc.
Food and Beverage
In-kind items and services
TRUMENBA General $16.63
AstraZeneca Pharmaceuticals LP
Food and Beverage
In-kind items and services
FARXIGA General $16.33
Eli Lilly and Company
Food and Beverage
In-kind items and services
MOUNJARO General $15.86
Eli Lilly and Company
Food and Beverage
In-kind items and services
MOUNJARO General $15.17
Novo Nordisk Inc
Food and Beverage
In-kind items and services
Ozempic General $15.01
Eli Lilly and Company
Food and Beverage
In-kind items and services
MOUNJARO General $14.20

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-12
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES OK 5366

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20240930001180

Enrollment State Jurisdiction

OK

PECOS Control ID

9537690771

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Good Shepherd Community Clinic, Inc.

1104 Walnut Dr, Ardmore, OK 734012353

Phone: 5802233411

Good Shepherd Community Clinic, Inc.

20 12th Ave Nw, Ardmore, OK 734015722

Phone: 5802233411

Good Shepherd Community Clinic, Inc.

2401 N Commerce St, Ardmore, OK 734011280

Phone: 5802260543

Good Shepherd Community Clinic, Inc.

1116 Walnut Dr, Ardmore, OK 734012353

Phone: 5802233411

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

17 listed
Anita Alaniz , MSN, WHNP, FNP-C

Nurse Practitioner - Primary Care

NPI 1205973377

Master of Science in Nursing, Women's Health Nurse Practitioner, Family Nurse Practitioner (Certified)

NPI 1871607903

Doctor of Medicine (M.D.)

Shawn Fadum , PA

Physician Assistant - Medical

NPI 1013374271

Physician Assistant

NPI 1700528510

Doctor of Osteopathic Medicine (D.O.)

Jo Fuller , APRN-CNP

Nurse Practitioner - Family

NPI 1427472083

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Sharon Hall , FNP

Nurse Practitioner - Family

NPI 1972616183

Family Nurse Practitioner

Career & Practice History

NPI enumerated August 12, 2024.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from September 2024 to August 2026.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1821829821
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 12, 2024
Last Update: August 12, 2024
Sole Proprietor: No

Other Physician Assistants in Ardmore

All Physician Assistants in Ardmore

Mailing Address

1104 Walnut Dr

Ardmore, OK 734012353

Phone: 5802233411

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.