Individual provider Active NPI

Ali S Zaza

  • Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1376522789
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20964 Issued in OK
Practice address
4200 W Memorial Rd
Suite 303
Oklahoma City, OK 73120-9350
Phone
(405) 936-9966
Fax
(405) 756-3341
NPI assigned
Jan 13, 2006
Last updated
Apr 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20964 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd
Suite 303
Oklahoma City, OK 73120-9350

Mailing address

4200 W Memorial Rd
Suite 303
Oklahoma City, OK 73120-9350
Phone (405) 936-9966

Other identifiers 1

IdentifierTypeStateIssuer
100061900AMedicaidOK

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929000509 OK Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 8123097128 Practice locations: Lindsay, OK; Oklahoma City, OK

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 S Main St
Suite a
Lindsay, OK 73052-5632
Phone (405) 756-3335

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nemri Medical Services, Inc. Past Accepting new patients
Pauls Valley Urgent Care LLC PastSince Nov 20, 2013 Accepting new patients
Summit Medical Center Past Accepting new patients
Urgent Care of Pauls Valley Aprn-CNP LLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Medical Wellness and Health LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: azaza76468@ouhealth.direct-ci.net

Organizations & group practices 7

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 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1376522789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "SUITE 303",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-936-9966",
            "fax_number": "405-756-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "SUITE 303",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-936-9966",
            "fax_number": "405-756-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAZA",
        "first_name": "ALI",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "20964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100061900A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.