NPIMap

Individual provider Active NPI

Vijay K Kolli, MD

  • Infectious Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1013017292
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
28955 Issued in OK
Practice address
1111 N Lee Ave Ste 249
Oklahoma City, OK 73103-2600
Phone
(405) 594-5848
Fax
(054) 594-5847
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 28955 OK Primary

Addresses

Primary practice location

1111 N Lee Ave Ste 249
Oklahoma City, OK 73103-2600

Mailing address

1104E State Highway 152
Mustang, OK 73064-5116
Phone (855) 541-2862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915000627 OK Practitioner - Infectious Disease 5092818922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crescent Infectious Diseases PLLCGroup PAC ID 8820222847, 7 clinicians

Practice addresses (Care Compare)

1111 N Lee Ave
Suite 249
Oklahoma City, OK 73103-2600
Phone 8555412862104

Hospital & facility affiliations

  • Centric Home Health Home health agency, Durant, OK, CCN 377791
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • Oklahoma Heart Hospital South, LLC Hospital, Oklahoma City, OK, CCN 370234
  • Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Okc-Amg Specialty Hospital Long-term care hospital, Oklahoma City, OK, CCN 372005

Merit-based Incentive Payment System (MIPS)

Final score
67.14 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
65.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue400
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Wound Care Specialist PLLC CurrentSince Oct 1, 2024 Accepting new patients
Crescent Infectious Diseases PLLC Infectious Disease CurrentSince Aug 1, 2015 Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients

Locations

1104 E State Highway 152
Mustang, OK 73064
Phone (405) 376-9544

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

4220 N Classen Blvd
Ste C
Oklahoma City, OK 73118
Phone (405) 900-4995

8200 National Ave
Oklahoma City, OK 73110
Phone (405) 737-8200

1145 W I 240 Service Rd
Ste F100
Oklahoma City, OK 73139
Phone (405) 898-9048

1111 N Lee Ave
Ste 249
Oklahoma City, OK 73103
Phone (214) 937-1387

Interoperability endpoints

  • FHIR API: https://epicrp.okheart.com/Oauth2Proxy/MYCHART/api/FHIR/R4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1013017292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104E STATE HIGHWAY 152",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645116",
            "telephone_number": "855-541-2862",
            "fax_number": "405-716-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N LEE AVE STE 249",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032600",
            "telephone_number": "405-594-5848",
            "fax_number": "054-594-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLI",
        "first_name": "VIJAY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OK",
            "license": "28955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.