Samara Ja'nel Jack , PA-C
Physician Assistant โข Tulsa, OK
7858 S Olympia Ave
Tulsa, OK 741321857
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on June 10, 2010; this date does not establish years in practice.
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Published CMS data list 68 Original Medicare Part B services in 2022.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022. Published rows only; this is not a quality measure.
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Published Part B service records, 2022:
- 99232 โ Subsequent hospital care with moderate levelof medical decision making: 38 service units.
- 99233 โ Subsequent hospital care with moderate levelof medical decision making: 19 service units.
- 99239 โ Hospital discharge day management: 11 service units.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022. Units differ by code; these are not visits or a measure of quality.
CPTยฎ only copyright 2021 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2022). CPT notice
See the full table ยท Guide: How to read Medicare Part B data
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Published CMS data list 14 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Gabapentin โ 14 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See the full table ยท Guide: How to read Medicare Part D prescriber data
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Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Tulsa, OK (2024, 201 clinicians with data). Median for this group: 213. Middle half: 63 to 584.
Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Oklahoma (2024, 938 clinicians with data). Median for this group: 239. Middle half: 62 to 934.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 322 in 2017 to 68 in 2022.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2017โ2022.
Practice Location & Contact Primary Location
7858 S Olympia Ave
Tulsa, OK 741321857
NPPES lists 1 additional practice-address record in Tulsa, OK. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
What Public CMS Data Show
Physician Assistant: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $4,751 in 2022
The total amount Medicare approved for these services in 2022. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022.
Paid by Medicare
About $3,807 in 2022
The part of the Medicare-allowed amount that Medicare itself paid in 2022, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2022.
30-day fills
14 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$53 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2024.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2021โ2025.
NPI first issued
2010
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.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
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, โDoes your provider accept Medicare as full payment?โ
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.
Enrolled in Medicare (PECOS)
Samara Jack 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.
Can order Medicare-covered services
CMS lists Samara Jack 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.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
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.
Compared with the same specialty in Tulsa and Oklahoma
Billing and prescribing volume is not a quality rating.
Medicare Part D prescriptions
Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Tulsa, OK (2024, 201 clinicians with data). Median for this group: 213. Middle half: 63 to 584.
Fewer Part D prescriptions than 90% of clinicians listed under Physician Assistant in Oklahoma (2024, 938 clinicians with data). Median for this group: 239. Middle half: 62 to 934.
Part D drug cost
A lower Part D drug cost than 95% of clinicians listed under Physician Assistant in Tulsa, OK (2024, 201 clinicians with data). Median for this group: $3,836. Middle half: $623 to $80,688.
A lower Part D drug cost than 95% of clinicians listed under Physician Assistant in Oklahoma (2024, 938 clinicians with data). Median for this group: $5,092. Middle half: $598 to $115,221.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Samara Jack are from 2022.
393 active clinicians are listed under Physician Assistant with a practice address in Tulsa, OK (1,870 in Oklahoma).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Tulsa
13.2% of these 393 clinicians have the CMS telehealth indicator.
73% of these 393 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 79% from 322 in 2017 to 68 in 2022.
- 2017: 322
- 2018: 317
- 2019: 44
- 2020: 17
- 2022: 68
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Medicare-allowed amount
Medicare-allowed amount decreased 73% from $17,373 in 2017 to $4,751 in 2022.
- 2017: $17,373
- 2018: $19,006
- 2019: $3,344
- 2020: $1,039
- 2022: $4,751
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Paid by Medicare
Paid by Medicare decreased 65% from $10,732 in 2017 to $3,807 in 2022.
- 2017: $10,732
- 2018: $11,843
- 2019: $1,851
- 2020: $870
- 2022: $3,807
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Medicare Part D prescriptions
Medicare Part D prescriptions went from 13 in 2016 to 14 in 2024.
- 2016: 13
- 2017: 51
- 2018: 505
- 2023: 15
- 2024: 14
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30-day fills
30-day fills went from 13 in 2016 to 14 in 2024.
- 2016: 13
- 2017: 51
- 2018: 958
- 2023: 15
- 2024: 14
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Part D drug cost
Part D drug cost went from $78 in 2016 to $53 in 2024.
- 2016: $78
- 2017: $749
- 2018: $28,897
- 2023: $42
- 2024: $53
Sources: CMS Medicare Physician & Other Practitioners (2022), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo ยท Report an error.
Performed Procedures & Service Volume
CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ2021 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ by Provider and Service data, 2017โ2022; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99232
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
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38 | 30 | $465.61 | $58.35 |
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99233
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
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19 | 13 | $691.68 | $83.69 |
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99239
Hospital discharge day management, more than 30 minutes
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11 | 11 | $678.45 | $85.79 |
Source: CMS Part B by Provider and Service, 2022; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Gabapentin | Gabapentin | 14 | 101 | $52.85 | 14 |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 363A00000X
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.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - PHYSICIAN ASSISTANT
I20110107000198
OK
6103015086
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Secondary Practice Locations
1705 E 19th St Ste 302
Tulsa, OK 741045410
Phone: 9187487585
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Emergency Medicine
Nurse Practitioner - Family
Advanced Practice Registered Nurse
Family Medicine
Doctor of Osteopathic Medicine (D.O.)
Family Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner - Family
Advanced Practice Registered Nurse - Certified Nurse Practitioner
Physician Assistant - Medical
Physician Assistant
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 1705 E 19TH ST STE 302, TULSA, OK 741045410 (Tel: 9187487585)
NPI status registered as active in NPPES database
Registered at 7858 S OLYMPIA AVE, TULSA, OK 741321857 (Tel: 9189869200)
Registered at 6600 S YALE AVE STE 1200, TULSA, OK 741363361 (Tel: 9184886687)
Recorded as SAMARA JACK, PA-C
Physician Assistant (license number reported to NPPES: OK 1919)
NPI status registered as active in NPPES database
Registered at 1717 S UTICA AVE STE A, TULSA, OK 741045346 (Tel: 9187481300)
Registered at 4848 S 129TH EAST AVE, TULSA, OK 741347001 (Tel: 9188326000)
Recorded as SAMARA JACK, PA-C
Physician Assistant (license number reported to NPPES: OK 1919)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Physician Assistants in Tulsa
- Carlos Lopez, PA
- Kjetil Lauritsen, PA-C
- Tamara Bennett-Nolley, PA-C
- Gannon Gill, PA
- Jordan Mcauliff, PA-C
- Anna Anthony, PA-C
Mailing Address
1705 E 19th St Ste 302
Tulsa, OK 741045410
Phone: 9187487585