Individual provider Active NPI

Nazanin Sara Hesami, DO

  • Family Medicine Physician
  • Moore, OK
National Provider Identifier
1013406099
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7259 Issued in OK
Practice address
320 N Service Rd
Moore, OK 73160-4945
Phone
(405) 794-4474
NPI assigned
May 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7259 OK Primary

Addresses

Primary practice location

320 N Service Rd
Moore, OK 73160-4945

Mailing address

320 N Service Rd
Moore, OK 73160-4945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502000897 OK Practitioner - Family Practice 9436546991 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Plains Medical Center Inc CurrentSince Feb 1, 2024 Accepting new patients
Southern Plains Medical Center Inc CurrentSince Feb 1, 2024 Accepting new patients

Locations

2222 W Iowa Ave
Chickasha, OK 73018

320 N Service Rd
Moore, OK 73160
Phone (405) 724-8383

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.

NPI Registry JSON

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

{
    "created_epoch": "1525564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1013406099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N SERVICE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N SERVICE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604945",
            "telephone_number": "405-794-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESAMI",
        "first_name": "NAZANIN",
        "middle_name": "SARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-06",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.