Individual provider Active NPI

Anibal Avila, M.D.

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1649213513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18774 Issued in OK
Practice address
1121 SW 44TH St
Oklahoma City, OK 73109-3601
Phone
(405) 634-4934
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18774 OK Primary

Addresses

Primary practice location

1121 SW 44TH St
Oklahoma City, OK 73109-3601

Mailing address

1121 SW 44TH St
Oklahoma City, OK 73109-3601
Phone (405) 634-4934

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
I20050203000725 OK Practitioner - Internal MedicinePractitioner - General Practice 2567413883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anibal Avila MD Professional Corporation PCGroup PAC ID 0143407205, 2 clinicians

Practice addresses (Care Compare)

5201 S Western Ave
Suite 200
Oklahoma City, OK 73109-4521
Phone (405) 634-4934

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18774OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anibal Avila MD Professional Corporation PC CurrentSince Jun 15, 2011 Accepting new patients
Nemri Medical Services, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

5201 S Western Ave
Ste 200
Oklahoma City, OK 73109
Phone (405) 634-4934

1111 SW 44th St
Oklahoma City, OK 73109
Phone (405) 702-4302

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649213513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 SW 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093601",
            "telephone_number": "405-634-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 SW 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093601",
            "telephone_number": "405-634-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "ANIBAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.