Active NPI
Nour Mustafa
- Physician Assistant
- Broken Arrow, OK
National Provider Identifier
1073119335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4419
- Practice address
- 2504 E Reno St
Broken Arrow, OK 74014-4601 - Phone
- (918) 406-8625
- NPI assigned
- Dec 10, 2020
- Last updated
- Dec 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4419 | OK | Primary |
Addresses
Primary practice location
2504 E Reno St
Broken Arrow, OK 74014-4601
Mailing address
2504 E Reno St
Broken Arrow, OK 74014-4601
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Oklahoma College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1409 Territories Dr
Edmond, OK 73034-2650
Phone (405) 657-3120
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.19 of 100
- Quality
- 95
- Improvement activities
- 40
- Cost
- 80.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hospitalist Physician
- Edmond, OK
- NPI 1598085359
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba INTEGRIS Health Edmond Hospital
- General Acute Care Hospital
- Edmond, OK
- NPI 1720373103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1073119335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 E RENO ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740144601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2504 E RENO ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740144601",
"telephone_number": "918-406-8625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSTAFA",
"first_name": "NOUR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-10",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "4419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.