Omid Roostaeyan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37981 Issued in OK

Practice address

18503 N Portland Ave
Edmond, OK 73012-9149

Phone

(405) 531-4271

NPI assigned

Apr 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Oklahoma College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oroostaeyan1177775@directc.mercy.net

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment Care Compare group NPD
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  NPD (past)
• Mercy Hospital Oklahoma City, Inc

  • Diagnostic Radiology Physician
  • Yukon, OK
  • NPI 1730326406
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc.

  • Home Health Agency
  • Oklahoma City, OK
  • NPI 1437256070
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1164929774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 N PORTLAND AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129149",
            "telephone_number": "405-531-4271",
            "fax_number": "405-531-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 N PORTLAND AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129149",
            "telephone_number": "405-531-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSTAEYAN",
        "first_name": "OMID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "37981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Montgomery Dental Group, PC
• Ronald Montgomery Dental Group, PC
• Ronisha Durham DDS PLLC
• Kristi Rook, LMT
• Room for Therapy PLLC
• Lisa Roper, PHARMD
• Rosado Consulting LLC
• Rosalynn J English, Ms,LMFT
• Kristen Michele Rosanelli, MA
• Cynthia Rose

• Family Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.

Verify at the official NPI Registry.