Individual provider Active NPI

Miraziz Ismoilov, MD

  • Nuclear Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1184328361
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
43655 Issued in OK
Practice address
940 NE 13TH St # 3210
Oklahoma City, OK 73104-5008
Phone
(405) 271-5125
NPI assigned
Mar 30, 2023
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 43655 OK Primary

Addresses

Primary practice location

940 NE 13TH St # 3210
Oklahoma City, OK 73104-5008

Mailing address

940 NE 13TH St # 3210
Oklahoma City, OK 73104-5008
Phone (405) 271-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43655OKMDNuclear Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1184328361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST # 3210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST # 3210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMOILOV",
        "first_name": "MIRAZIZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "OK",
            "license": "43655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.