Mona Bahavar, DO
Individual provider Active NPI Pediatrics Physician · Oklahoma City, OK
NPI 1508489642 · NPPES record last updated Jul 12, 2023
Key facts
- NPI
- 1508489642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 7345 (OK)
- Practice address
- 500 SW 44TH St
Oklahoma City, OK 73109-3540 - Phone
- (405) 632-6688
- NPI assigned
- May 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230727002773 | OK | Practitioner - Pediatric Medicine | 2264893973 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Variety Care, Inc. | Current |
Accepting new patients | |
| Variety Care, Inc. | Current | Accepting new patients | |
| Variety Care, Inc. | Current |
Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
500 SW 44th St
Oklahoma City, OK 73109
Phone (405) 235-6466
3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209
Interoperability endpoints
- mbahavar651550@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 7345 | OK | Yes |
Addresses
Primary practice location
500 SW 44TH St
Oklahoma City, OK 73109-3540
Mailing address
3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688
Other providers in Oklahoma City, OK
- Katelyn Baggs
- Jimmy Bagsby
- Huliamatu Bah
- Jamie M Baham
- Cody Bahavar
- Ahmed Tarek Bahnaswy
- Rhiannon Bahnmaier
- Arya Bahreini
- Sakshi Bai
- Matthew P Baier
All providers in Oklahoma City, OK · Pediatrics Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.