CMS-1500 Box 24J / 33a • NPI
1356811558
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
1322 KLABZUBA AVE, PRAGUE, OK, 74864-4900
✓ 9-Digit EDI 837 ZIP+4 (74864-4900)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1356811558 (CRYSTAL A MAHANA, PA-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1356811558)
Medicare Beneficiaries
53
Total Billed Services
66
Distinct CPT/HCPCS Codes
15
Medicare Allowed Total
$5,431.24
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99284 | Emergency department visit with moderate level of medical decision making | 22 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amoxicillin-Clavulanate Potass Amoxicillin/Potassium Clav | 12 | 12 |
| Cefdinir Cefdinir | 16 | 16 |
| Cephalexin Cephalexin | 13 | 13 |
| Cyclobenzaprine Hcl Cyclobenzaprine Hcl | 19 | 18 |
| Naproxen Naproxen | 21 | 20 |
| Ondansetron Hcl Ondansetron Hcl | 14 | 13 |
| Prednisone Prednisone | 20 | 19 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1356811558 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | CRYSTAL A MAHANA, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1322 KLABZUBA AVE, PRAGUE, OK, 74864-4900 |
| Practice Telephone / Fax | Tel: (405) 567-4922 |
| Administrative Mailing Address | 2732 NW 155TH ST, EDMOND, OK, 73013-8812 |
| Enumeration & Last Sync | Enumerated: 2018-11-29 | CMS Record Updated: 2025-04-28 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CRYSTAL A MAHANA, PA-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: OK | License: 2955 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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