Moriam Bolare NA-Allah

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

111165 Issued in OK

Practice address

2712 Greenfield Dr
Edmond, OK 73012-6531

Phone

(405) 923-0952

NPI assigned

Sep 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of OklahomaGroup PAC ID 4486558962, 99 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• State of Oklahoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norman, OK
  • NPI 1588755532
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OK

  Medicare reassignment NPD
• State of Oklahoma

  • Skilled Nursing Facility
  • Talihina, OK
  • NPI 1154589430
  NPD
• State of Oklahoma

  • Psychiatric Hospital
  • Fort Supply, OK
  • NPI 1922171701
  NPD
• State of Oklahoma

  • Medical Specialty Clinic/Center
  • Woodward, OK
  • NPI 1750456588
  NPD (past)

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1285283176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 GREENFIELD DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730126531",
            "telephone_number": "405-923-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 GREENFIELD DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730126531",
            "telephone_number": "405-923-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NA-ALLAH",
        "first_name": "MORIAM",
        "middle_name": "BOLARE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "111165",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "111165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA BOARD OF NURSING",
            "identifier": "111165",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myers Counseling & Consulting, PC
• Miranda Elaine Myers, M.ED
• Tiffanie Leigh Myers, PHARM. D.
• Carly Myrick
• Astou N'Diaye
• Elizabeth Nabavi
• Golnaz Naghdi, DDS
• Kamlesh H Naik, MD
• Nalin U.G., DO PLLC
• Ruchi Nanda, D.D.S., M.S., P.C.

• Psychiatric/Mental Health Nurse Practitioner in Edmond, OK
• Providers in Edmond, OK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2023; 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.