Individual provider Active NPI

Mahmood Hussain Khichi, M.D.

  • Pediatric Critical Care Medicine Physician
  • Tulsa, OK
National Provider Identifier
1083658447
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
18439 Issued in OK
Practice address
6161 S Yale Ave
Picu
Tulsa, OK 74136-1902
Phone
(918) 502-6135
NPI assigned
Jun 16, 2006
Last updated
Mar 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 18439 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Picu
Tulsa, OK 74136-1902

Mailing address

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347
Phone (918) 488-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031201000464 OK Practitioner - Critical Care (Intensivists)Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 0648175984 Reassigns benefits to 1 organization
I20190827000221 TX Practitioner - Pediatric Medicine 0648175984 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. CurrentSince Apr 20, 2019 Accepting new patients
Pediatric Intensive Care Services Inc Pediatric Critical Care Medicine Past Accepting new patients
Integris Baptist Associates Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Texas Children's Hospital Past Accepting new patients
El Paso Children's Hospital Corporation Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Washita Emergency Physicians LLC Past Accepting new patients

Locations

6621 Fannin St
Ste W6006
Houston, TX 77030
Phone (832) 824-5952

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Interoperability endpoints

  • Direct secure messaging: mkhichi7522@direct.saintfrancis.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1083658447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "address_2": "SUITE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347",
            "telephone_number": "918-488-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "address_2": "PICU",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-502-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHICHI",
        "first_name": "MAHMOOD",
        "middle_name": "HUSSAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OK",
            "license": "18439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.