Ali Nawaz LLC

Organization Active NPI Endocrinology, Diabetes & Metabolism Physician · Edmond, OK

NPI 1013725977 · NPPES record last updated Apr 10, 2025

Key facts

NPI
1013725977
Entity type
Organization (NPI type 2)
Primary specialty
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Legal business name
ALI NAWAZ LLC
Practice address
2940 Hunter Crest Dr
Edmond, OK 73034-0021
Phone
(917) 558-4195
NPI assigned
Dec 24, 2024
Organization subpart
No

Authorized official

Name
Ali Tipu, MD NPI 1518218304
Title
Owner and Ceo
Phone
(917) 558-4195

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250515003579 OK Part B Supplier - Clinic/Group Practice 6709304462 Receives reassigned benefits from 1 practitioner
Practice locations: Edmond, OK; Oklahoma City, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RE0101X Yes

Addresses

Primary practice location

2940 Hunter Crest Dr
Edmond, OK 73034-0021

Mailing address

2940 Hunter Crest Dr
Edmond, OK 73034-0021

Other names

  • Endo Balance PLLC Doing business as

Other providers in Edmond, OK

All providers in Edmond, OK · Endocrinology, Diabetes & Metabolism Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.