NPIMap

Organization Active NPI

Prime Medical Group Corp

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1063153369
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
PRIME MEDICAL GROUP CORP
Practice address
10505 E 91St St Ste 205
Tulsa, OK 74133-5829
Phone
(918) 307-5490
NPI assigned
Apr 2, 2022
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Hassan Awad AbouhouliNPI 1366564304
Title
Owner
Phone
(918) 307-5490

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

10505 E 91St St Ste 205
Tulsa, OK 74133-5829

Mailing address

1611 S Utica Ave # 243
Tulsa, OK 74104-4909
Phone (918) 307-5490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220531002008 OK Part B Supplier - Clinic/Group Practice 9032597257 Receives reassigned benefits from 21 practitioners
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

744 W 9th St
Fl 5
Tulsa, OK 74127
Phone (918) 932-3700

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1063153369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S UTICA AVE # 243",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044909",
            "telephone_number": "918-307-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 E 91ST ST STE 205",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335829",
            "telephone_number": "918-307-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-02",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "ABOUHOULI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "AWAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-307-5490"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.