Yeganeh Azimi, PAC
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Tulsa, OK
NPI 1063289247 · NPPES record last updated Dec 7, 2023
Key facts
- NPI
- 1063289247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- 5141 (OK)
- Practice address
- 1145 S Utica Ave Ste 365
Tulsa, OK 74104-4004 - Phone
- (918) 728-3354
- NPI assigned
- Dec 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Creek Nation Hospital and Clinics
Green Country Emergency Physicians Group of Tulsa, PLLC
Practice addresses (Care Compare)
10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333
1202 N Muskogee PL
Claremore, OK 74017-3058
Phone (918) 341-2556
1313 E 20TH St
Okmulgee Indian Health Center
Okmulgee, OK 74447-6303
Phone (918) 591-5700
1800 E Coplin St
Okemah, OK 74859-4642
Phone (918) 623-1424
Hospital & facility affiliations
- Council Oak Comprehensive Healthcare
- Creek Nation Community Hospital
- Hillcrest Hospital South
- Muscogee (Creek) Nation Medical Center
- Bailey Medical Center, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240201003301 | OK | Practitioner - Physician Assistant | 2264885565 | Reassigns benefits to 2 organizations |
| I20240903002352 | TX | Practitioner - Physician Assistant | 2264885565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Nation Hospital & Clinics | Current |
Accepting new patients | |
| Green Country Emergency Physicians Group of Tulsa PLLC | Current |
Accepting new patients | |
| Creek Nation Hospital & Clinics | Past | Accepting new patients | |
| Ahs Claremore Regional Hospital, LLC. | Past | Accepting new patients | |
| Creek Nation Hospital & Clinics | Past | Accepting new patients | |
| Ahs Southcrest Hospital, LLC | Past | Accepting new patients | |
| Creek Nation Hospital & Clinics | Past | Accepting new patients |
Locations
1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556
1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915
2401 W Main St
Henryetta, OK 74437
Phone (918) 650-1100
900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448
Dept 1467
Tulsa, OK 74182
1145 S Utica Ave
Ste 365
Tulsa, OK 74104
Phone (402) 481-3548
1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090
10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760
Interoperability endpoints
- yazimi21879@muscogeecreeknation.direct-ci.com
- yazimi1136814@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 5141 | OK | Yes |
Addresses
Primary practice location
1145 S Utica Ave Ste 365
Tulsa, OK 74104-4004
Mailing address
1157 E 148TH St S
Glenpool, OK 74033-4407
Phone (918) 852-7056
Other providers in Tulsa, OK
- Latonya Ayoh
- Az Surgery Neuromonitoring LLC
- Reza John Azadi
- Marnie Burggraff Azadian
- Maureen Hieronymus Azarian
- Elias Aziz
- Aznm LLC
- Mark Tony Azzam
- Saramarie Osaima Azzun
- B & B Medical Services Inc
All providers in Tulsa, OK · Emergency Medical Services (Emergency Medicine) Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.