Individual provider Active NPI

Ahmad Al-Taee, M.D.

  • Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1467837880
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
43817 Issued in OK
Practice address
4200 W Memorial Rd Ste 310
Oklahoma City, OK 73120-8378
Phone
(405) 749-7014
Fax
(405) 749-7024
NPI assigned
Jul 27, 2015
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2015018261 MO
Gastroenterology Physician 207RG0100X 2015018261 MO
Gastroenterology Physician 207RG0100X 036161290 IL
Gastroenterology Physician 207RG0100X 43817 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd Ste 310
Oklahoma City, OK 73120-8378

Mailing address

4200 W Memorial Rd Ste 310
Oklahoma City, OK 73120-8378
Phone (405) 749-7014

Other practice location 1

530 1st Ave # Hcc4G
New York, NY 10016-6402
Phone (646) 501-2465

Other practice location 2

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aaltaee456794@nyumc.direct-ci.com
Direct Messaging Address aaltaee244377@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OK, ME3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220916000687 IL Practitioner - Gastroenterology 8729381645 Reassigns benefits to 2 organizations
I20240919002718 OK Practitioner - Gastroenterology 8729381645 Reassigns benefits to 1 organization
I20251118002839 ME Practitioner - GastroenterologyPractitioner - Internal Medicine 8729381645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372

417 State St
Suite 121
Bangor, ME 04401-6630
Phone (207) 973-4266

4200 W Memorial Rd
Suite 310
Oklahoma City, OK 73120-8378
Phone (405) 749-4222

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux609

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036161290ILMDGastroenterology Physician
2015018261MOMDGastroenterology Physician
43817OKMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group Gastroenterology CurrentSince Aug 15, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Feb 6, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Feb 6, 2024 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Sep 16, 2024 Accepting new patients
Eastern Maine Medical Center CurrentSince Sep 28, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince Sep 28, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
SSM Health Care Group PastSince Dec 1, 2020 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

417 State St
Ste 121
Bangor, ME 04401
Phone (207) 947-0147

489 State St
Bangor, ME 04401
Phone (207) 973-8837

4200 W Memorial Rd
Ste 310
Oklahoma City, OK 73120
Phone (405) 749-4222

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

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

Interoperability endpoints

  • Direct secure messaging: aaltaee456794@nyumc.direct-ci.com
  • Direct secure messaging: aaltaeemd353016@carlehiedirect.net

Organizations & group practices 10

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 6

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": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1467837880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD STE 310",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208378",
            "telephone_number": "405-749-7014",
            "fax_number": "405-749-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD STE 310",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208378",
            "telephone_number": "405-749-7014",
            "fax_number": "405-749-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 1st Ave # Hcc4G",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "646-501-2465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-TAEE",
        "first_name": "AHMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2015018261",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2015018261",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036161290",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "43817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aaltaee456794@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave # Hcc4G",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aaltaee244377@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.