NPIMap

Individual provider Active NPI

Nedal Amin Elass, M.D.

  • Family Medicine Physician
  • Kingston, OK
National Provider Identifier
1437546140
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33623 Issued in OK
Practice address
701 Highway 70 E
Kingston, OK 73439-8253
Phone
(580) 564-7405
NPI assigned
Apr 20, 2015
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 33623 OK Primary

Addresses

Primary practice location

701 Highway 70 E
Kingston, OK 73439-8253

Mailing address

901 S 5TH Ave
Madill, OK 73446-3640
Phone (580) 795-3384

Other practice location 1

901 S 5th Ave
Madill, OK 73446-3640
Phone (580) 795-3384

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nedal.elass.1@4696.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180919002786 OK Practitioner - Family Practice 2264746858 Reassigns benefits to 1 organization
I20210329002011 TX Practitioner - Family Practice 2264746858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone (918) 421-6987

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33623OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health CurrentSince Mar 3, 2021 Accepting new patients
McAlester Regional Health Center Authority CurrentSince Mar 7, 2024 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Mar 3, 2021 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center Past Accepting new patients
Marshall County Hma LLC Family Medicine Past Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

1 E Clark Bass Blvd
#H
McAlester, OK 74501
Phone (918) 421-6941

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Organizations & group practices 5

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 7

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1437546140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S 5TH AVE",
            "city": "MADILL",
            "state": "OK",
            "postal_code": "734463640",
            "telephone_number": "580-795-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HIGHWAY 70 E",
            "city": "KINGSTON",
            "state": "OK",
            "postal_code": "734398253",
            "telephone_number": "580-564-7405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Madill",
            "state": "OK",
            "postal_code": "734463640",
            "country_code": "US",
            "telephone_number": "580-795-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELASS",
        "first_name": "NEDAL",
        "middle_name": "AMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "33623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nedal.elass.1@4696.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "701 Highway 70 E",
            "city": "Kingston",
            "state": "OK",
            "country_code": "US",
            "postal_code": "734398253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, OK

Sources for this page

Verify at the official NPI Registry.