NPIMap

Individual provider Active NPI

Shirin N Mohammad, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1093742819
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21819 Issued in OK
Practice address
4221 S Western Ave
Suite 3030
Oklahoma City, OK 73109-3447
Phone
(405) 636-7650
Fax
(405) 636-7743
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21819 OK Primary

Addresses

Primary practice location

4221 S Western Ave
Suite 3030
Oklahoma City, OK 73109-3447

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 636-7650

Other identifiers 1

IdentifierTypeStateIssuer
100034180BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001028 OK Practitioner - Internal Medicine 5890683759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

4221 S Western Ave
Suite 3030
Oklahoma City, OK 73109-3492
Phone (405) 636-7650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

4221 S Western Ave
Ste 3010
Oklahoma City, OK 73109
Phone (405) 636-7450

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

4221 S Western Ave
Ste 3030
Oklahoma City, OK 73109
Phone (405) 636-7650

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Interoperability endpoints

  • Direct secure messaging: smohammad14447@direct.integrisok.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1093742819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-636-7650",
            "fax_number": "405-636-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "SUITE 3030",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-636-7650",
            "fax_number": "405-636-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMAD",
        "first_name": "SHIRIN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "21819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100034180B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.