Individual provider Active NPI

Muhammad Fawad Ishfaq, MD

  • Vascular Neurology Physician
  • Oklahoma City, OK
National Provider Identifier
1558717645
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
43761 Issued in OK
Practice address
3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone
(405) 949-3417
Fax
(405) 552-5165
NPI assigned
May 9, 2016
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 79029 MN
Vascular Neurology Physician 2084V0102X 43761 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Oklahoma City, OK 73112-4418

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 949-3417

Other practice location 1

3366 NW Expressway Ste 200
Oklahoma City, OK 73112-4416
Phone (405) 713-9930

Other practice location 2

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 1

IdentifierTypeStateIssuer
200096230MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MN2 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
I20240820003255 OK Practitioner - Neurology 1355631896 Reassigns benefits to 2 organizations
I20250422000999 MN Practitioner - Neurology 1355631896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibmc ER PhysiciansGroup PAC ID 6709963085, 16 clinicians
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

3366 NW Expressway
200 Integris Neurology North
Oklahoma City, OK 73112-4416
Phone (405) 713-9930

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79029MNMDVascular Neurology Physician
43761OKMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD CurrentSince May 15, 2025 Accepting new patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Aug 1, 2022 Accepting new patients
University of Kentucky CurrentSince Aug 1, 2022 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 15, 2025 Accepting new patients
Ibmc ER Physicians CurrentSince Aug 30, 2024 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Aug 30, 2024 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3366 NW Expressway St
Ste 200
Oklahoma City, OK 73112
Phone (405) 713-9930

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

Interoperability endpoints

  • Direct secure messaging: mishfaq492772@direct.integrisok.com
  • Direct secure messaging: mishfaq244396@ukhcdirect.org

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, 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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1558717645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-949-3417",
            "fax_number": "405-552-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3417",
            "fax_number": "405-552-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3366 NW Expressway Ste 200",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124416",
            "country_code": "US",
            "telephone_number": "405-713-9930",
            "fax_number": "405-713-9931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHFAQ",
        "first_name": "MUHAMMAD",
        "middle_name": "FAWAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MN",
            "license": "79029",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OK",
            "license": "43761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200096230",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "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.