Individual provider Active NPI

Moluk Mirrasouli Ragland, D.O.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1407094873
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N1423 Issued in TX
Practice address
7003 S New Braunfels Ave
San Antonio, TX 78223-4588
Phone
(678) 501-2814
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 N1423 TX Primary

Addresses

Primary practice location

7003 S New Braunfels Ave
San Antonio, TX 78223-4588

Mailing address

2575 Northwinds Pkwy
Alpharetta, GA 30009-2232

Other practice location 1

3503 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1225
Phone (210) 492-8922

Other names 1

  • Miss Moluk Sadat Mirrasouli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240301000138 MN Practitioner - Nurse Practitioner 2567636202 Reassigns benefits to 2 organizations
I20250818003232 OK Practitioner - Family Practice 2567636202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aitkin Community Hospital IncGroup PAC ID 4981514692, shared by 7 NPIs, 96 clinicians

Practice addresses (Care Compare)

200 Bunker Hill Dr
Aitkin, MN 56431-1865
Phone (218) 927-2121

Hospital & facility affiliations

  • Riverwood Healthcare Center Hospital, Aitkin, MN, CCN 241305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1423TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aitkin Community Hospital, Inc. Current Accepting new patients
Aitkin Community Hospital, Inc. CurrentSince Dec 15, 2023 Accepting new patients
Aitkin Community Hospital, Inc. CurrentSince Dec 15, 2023 Accepting new patients
Warren Clinic Inc CurrentSince Sep 1, 2025 Accepting new patients
Aitkin Community Hospital, Inc. Current Accepting new patients
Health by Design Medical Group PastSince Nov 3, 2024 Accepting new patients

Locations

200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6160 S Yale Ave
Tulsa, OK 74136
Phone (918) 492-7200

Organizations & group practices 6

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 1

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": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1407094873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 NORTHWINDS PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 S NEW BRAUNFELS AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234588",
            "telephone_number": "678-501-2814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3503 Paesanos Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782311225",
            "country_code": "US",
            "telephone_number": "210-492-8922",
            "fax_number": "210-479-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGLAND",
        "first_name": "MOLUK",
        "middle_name": "MIRRASOULI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLUK",
            "last_name": "MIRRASOULI",
            "middle_name": "SADAT",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.