Individual provider Active NPI

Hafsat Umar Mashegu, MD

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1356667372
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
27719 Issued in OK
Practice address
4502 E 41St St
Tulsa, OK 74135-9923
Phone
(918) 660-3416
Fax
(918) 660-3426
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27719 OK Primary

Addresses

Primary practice location

4502 E 41St St
Tulsa, OK 74135-9923

Mailing address

5217 S Vandalia Ave
Apt 1C
Tulsa, OK 74135-4058
Phone (770) 994-0420

Other names 1

  • Hafsat Omar Mohammed Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160919000310 PA Practitioner - Pediatric Medicine 4587988126 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27719OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Aug 1, 2016 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Aug 1, 2016 Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1356667372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 S VANDALIA AVE",
            "address_2": "APT 1C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354058",
            "telephone_number": "770-994-0420",
            "fax_number": "770-994-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741359923",
            "telephone_number": "918-660-3416",
            "fax_number": "918-660-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHEGU",
        "first_name": "HAFSAT",
        "middle_name": "UMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "27719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAFSAT",
            "last_name": "MOHAMMED",
            "middle_name": "OMAR",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.