Individual provider Active NPI

Ali Chaudahry, APRN

  • Acute Care Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1164123451
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
211984 Issued in OK
Practice address
1 S Bryant Ave
Edmond, OK 73034-6309
Phone
(405) 359-5370
NPI assigned
Mar 14, 2023
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 211984 OK Primary

Addresses

Primary practice location

1 S Bryant Ave
Edmond, OK 73034-6309

Mailing address

1 S Bryant Ave
Edmond, OK 73034-6309
Phone (405) 359-5370

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526002150 OK Practitioner - Nurse Practitioner 5496112914 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Optimum Pac PLLCGroup PAC ID 3476052283, 10 clinicians

Practice addresses (Care Compare)

308 NW 153Rd St
Edmond, OK 73013-1173
Phone (405) 376-9544

Merit-based Incentive Payment System (MIPS)

Final score
60.58 of 100Reported as group
Quality
72.72
Promoting interoperability
0
Improvement activities
30
Cost
63.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Post Acute Care PLLC CurrentSince Jun 10, 2023 Accepting new patients
Optimum Care Hospitalist Group PLLC CurrentSince Apr 15, 2023 Accepting new patients
Midwest Hospitalist Group PLLC CurrentSince Oct 1, 2023 Accepting new patients
Optimum Pac PLLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1 S Bryant Ave
Edmond, OK 73034
Phone (405) 341-6100

1501 E 19th St
Edmond, OK 73013
Phone (405) 348-6611

1104 E State Highway 152
#1
Mustang, OK 73064
Phone (405) 376-9544

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

Organizations & group practices 5

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1164123451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346309",
            "telephone_number": "405-359-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346309",
            "telephone_number": "405-359-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDAHRY",
        "first_name": "ALI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "211984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.