NPIMap

Individual provider Active NPI

Mazen Al-Hamwy, M.D.

  • Cardiovascular Disease Physician
  • Muskogee, OK
National Provider Identifier
1316021165
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
23969 Issued in OK
Practice address
3720 W Broadway St
Muskogee, OK 74401-2141
Phone
(918) 910-5301
Fax
(918) 910-5279
NPI assigned
Oct 25, 2006
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 23969 OK Primary

Addresses

Primary practice location

3720 W Broadway St
Muskogee, OK 74401-2141

Mailing address

701 E Decatur St
Broken Arrow, OK 74011-3575
Phone (918) 348-9715

Other identifiers 2

IdentifierTypeStateIssuer
200041600AMedicaidOK
P00182660OtherRR MEDICARE

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
I20041222000138 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7012975014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3720 W Broadway St
Muskogee, OK 74401-2141
Phone (918) 910-5301

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.88 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
74.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23969OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Heart Clinic, P.C. Cardiovascular Disease CurrentSince Jul 8, 2018 Accepting new patients
Cardiac Imaging Inc CurrentSince Feb 12, 2019 Accepting new patients
Chandrasekhar Polepalle MD Inc PastSince Jul 25, 2019 Accepting new patients

Locations

3720 W Broadway St
Muskogee, OK 74401
Phone (918) 683-5939

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19201/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mazen.al-hamwy.1@14254.direct.athenahealth.com
  • Direct secure messaging: mazen.al-hamwy.1@19201.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1316021165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E DECATUR ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740113575",
            "telephone_number": "918-348-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012141",
            "telephone_number": "918-910-5301",
            "fax_number": "918-910-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HAMWY",
        "first_name": "MAZEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "23969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200041600A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00182660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.