Individual provider Active NPI

Julia Reza, M.D.

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1023220936
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
28378 Issued in OK
Practice address
4023 NW 10TH St
Oklahoma City, OK 73107-6038
Phone
(405) 632-6688
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M9608 TX
Pediatrics Physician 208000000X 28378 OK Primary

Addresses

Primary practice location

4023 NW 10TH St
Oklahoma City, OK 73107-6038

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

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
I20111205000411 OK Practitioner - Pediatric Medicine 2365507548 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9608TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. CurrentSince Sep 29, 2016 Accepting new patients
Variety Care, Inc CurrentSince Sep 29, 2016 Accepting new patients
Variety Care, Inc. Current Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

500 SW 44th St
Oklahoma City, OK 73109
Phone (405) 235-6466

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

4023 NW 10th St
Oklahoma City, OK 73107

Interoperability endpoints

  • Direct secure messaging: jreza376674@direct.ochin.org

Organizations & group practices 4

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1023220936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 NW 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076038",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZA",
        "first_name": "JULIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M9608",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "28378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.