NPIMap

Individual provider Active NPI

Sobhan Daneshfar

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1295237998
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7156 Issued in OK
Practice address
13500 S Tulsa Dr Ste 200
Oklahoma City, OK 73170
Phone
(405) 713-2696
Fax
(405) 713-2699
NPI assigned
Mar 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7156 OK Primary

Addresses

Primary practice location

13500 S Tulsa Dr Ste 200
Oklahoma City, OK 73170

Mailing address

13500 S Tulsa Dr Ste 200
Oklahoma City, OK 73170-9720
Phone (405) 713-2696

Other practice location 1

1111 W 17th St
Tulsa, OK 74107-1886
Phone (918) 582-1972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721000547 OK Practitioner - Family Practice 2163803271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068
Phone (405) 231-3000

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7156OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC Family Medicine CurrentSince Jul 15, 2022 Accepting new patients
Saints Medical Group, LLC CurrentSince Jul 15, 2022 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

13500 S Tulsa Dr
Ste 200
Oklahoma City, OK 73170
Phone (405) 713-2696

13500 S Tulsa Dr
Oklahoma City, OK 73170
Phone (405) 713-2696

Interoperability endpoints

  • Direct secure messaging: sdaneshfar428025@direct-ehr-ssmhc.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1295237998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 S TULSA DR STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731709720",
            "telephone_number": "405-713-2696",
            "fax_number": "405-713-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 S TULSA DR STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73170",
            "telephone_number": "405-713-2696",
            "fax_number": "405-713-2699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W 17th St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741071886",
            "country_code": "US",
            "telephone_number": "918-582-1972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANESHFAR",
        "first_name": "SOBHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.