Individual provider Active NPI

Omar A Abu Anza, MD

  • Pediatric Cardiology Physician
  • Oklahoma City, OK
National Provider Identifier
1629465802
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
38427 Issued in OK
Practice address
1200 Everett Dr # Np2350
Oklahoma City, OK 73104-5047
Phone
(405) 271-5530
NPI assigned
Apr 25, 2015
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 38427 OK Primary

Addresses

Primary practice location

1200 Everett Dr # Np2350
Oklahoma City, OK 73104-5047

Mailing address

1200 Everett Dr
Oklahoma City, OK 73104-5047
Phone (452) 271-4411

Other practice location 1

219 Bryant St
Buffalo, NY 14222-2006
Phone (716) 878-7432

Other practice location 2

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 353-8105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210914000821 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 1254737414 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-2669

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Pediatric Cardiology CurrentSince Jul 15, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Aug 16, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 15, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Aug 16, 2021 Accepting new patients
Mercy Hospital Oklahoma City, Inc CurrentSince Jul 17, 2023 Accepting new patients
Mercy Hospital Oklahoma City, Inc Current Accepting new patients
Summit Medical Center Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Ste 3200
Sacramento, CA 95817
Phone (916) 734-3112

1200 Childrens Ave
Ste 2F
Oklahoma City, OK 73104
Phone (405) 271-4411

1200 Everett Dr
Oklahoma City, OK 73104
Phone (405) 271-2429

1200 Everett Dr
#2350
Oklahoma City, OK 73104
Phone (405) 271-4411

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

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: oabuanza29988@ouhealth.direct-ci.net

Organizations & group practices 11

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 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": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1629465802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "452-271-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR # NP2350",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "405-271-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142222006",
            "country_code": "US",
            "telephone_number": "716-878-7432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-353-8105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABU ANZA",
        "first_name": "OMAR",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-25",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OK",
            "license": "38427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.