Abdelrahman Abdalla
Individual provider Active NPI Internal Medicine Physician · Oklahoma City, OK
NPI 1104569227 · NPPES record last updated Jun 30, 2025
Key facts
- NPI
- 1104569227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 45584 (OK)
- Practice address
- 700 NE 13TH St
Oklahoma City, OK 73104-5004 - Phone
- (405) 271-5882
- Fax
- (405) 271-1476
- NPI assigned
- Apr 16, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ou Health Partners Inc
Practice addresses (Care Compare)
900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065
Hospital & facility affiliations
- O U Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250804000217 | OK | Practitioner - Internal Medicine | 9537549449 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45584 | OK | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ou Health Partners, Inc | Current |
Accepting new patients | |
| Ou Health Partners, Inc | Current |
Accepting new patients | |
| Ou Medicine Inc. | Past | Accepting new patients |
Locations
700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667
900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230
Interoperability endpoints
- aabdalla643121@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 45584 | OK | Yes |
Addresses
Primary practice location
700 NE 13TH St
Oklahoma City, OK 73104-5004
Mailing address
2330 California St Apt 7
Mountain View, CA 94040-4705
Phone (650) 861-9010
NPI Registry JSON
{
"created_epoch": "1650067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1104569227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 CALIFORNIA ST APT 7",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940404705",
"telephone_number": "650-861-9010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 NE 13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045004",
"telephone_number": "405-271-5882",
"fax_number": "405-271-1476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDALLA",
"first_name": "ABDELRAHMAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-16",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "45584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
- Jordan Abbott
- Matthew Ryan Abbott
- Michele Leigh Abbott
- Phuong Kim Abbott
- Abc Pediatric Rehab LLC
- Ahmad Abdel-Aty
- Nadine Abdelkader
- Tony Abdo
- Marese Pagwuni Abdul Kaleem
- Jalelah Abdul-Raheem
All providers in Oklahoma City, OK · Internal 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 Jun 30, 2025. 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.