NPIMap

Individual provider Active NPI

Mohammad Hassan Raza, MD

  • Internal Medicine Physician
  • Ada, OK
National Provider Identifier
1376163667
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41094 Issued in OK
Practice address
430 N Monte Vista St
Ada, OK 74820-4610
Phone
(580) 332-2323
Fax
(580) 421-1236
NPI assigned
Apr 16, 2020
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41094 OK Primary

Addresses

Primary practice location

430 N Monte Vista St
Ada, OK 74820-4610

Mailing address

430 N Monte Vista St
Ada, OK 74820-4610
Phone (580) 332-2323

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
I20230803001281 OK Practitioner - Internal MedicinePractitioner - Hospitalist 9032570254 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady Memorial HospitalGroup PAC ID 0648175778, shared by 6 NPIs, 47 clinicians
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

2220 W Iowa Ave
Professional Medical Services
Chickasha, OK 73018-2738
Phone (405) 224-2300

430 N Monte Vista St
Ada, OK 74820-4610
Phone (580) 332-2323

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Ou Health Partners, Inc CurrentSince Nov 11, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Nov 11, 2024 Accepting new patients
Mercy Hospital Tishomingo, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Mercy Hospital Tishomingo, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Mercy Hospital Tishomingo, Inc Current Accepting new patients
Ou Medicine Inc. Past Accepting new patients
Mercy Hospital Ada, Inc Past Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327

Organizations & group practices 8

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 11

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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1376163667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204610",
            "telephone_number": "580-332-2323",
            "fax_number": "580-421-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204610",
            "telephone_number": "580-332-2323",
            "fax_number": "580-421-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "MOHAMMAD",
        "middle_name": "HASSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "41094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.