NPIMap

Individual provider Active NPI

William A Collazo, M.D., F.A.C.C.

  • Cardiovascular Disease Physician
  • Oklahoma City, OK
National Provider Identifier
1649290594
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17633 Issued in OK
Practice address
1211 N Shartel Ave Ste 1006
Oklahoma City, OK 73103-2433
Phone
(405) 546-7699
Fax
(405) 546-7795
NPI assigned
Jul 20, 2006
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 17633 OK Primary

Addresses

Primary practice location

1211 N Shartel Ave Ste 1006
Oklahoma City, OK 73103-2433

Mailing address

1211 N Shartel Ave Ste 1006
Oklahoma City, OK 73103-2433
Phone (405) 546-7699

Other identifiers 1

IdentifierTypeStateIssuer
100256940AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226001102 OK Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8325934169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Baylor College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7278

1211 N Shartel Ave
Suite 1006
Oklahoma City, OK 73103-2433
Phone (405) 546-7699

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.73 of 100Reported as individual
Quality
55.91
Improvement activities
40
Cost
61.23

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc Cardiovascular Disease CurrentSince Oct 7, 2023 Accepting new patients
Neuro Dynamics LLC CurrentSince Sep 1, 2025 Accepting new patients
William a Collazo, M.D., F.a.C.C. Cardiovascular Disease CurrentSince Sep 25, 2012 Accepting new patients
Cardiac Imaging Inc CurrentSince Nov 8, 2017 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Birth and Beyond PC PastSince Sep 25, 2012 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

1211 N Shartel Ave
Ste 1006
Oklahoma City, OK 73103
Phone (405) 235-4149

3400 S Douglas Blvd
Ste 200
Oklahoma City, OK 73150
Phone (405) 272-2850

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 4106
Oklahoma City, OK 73102
Phone (405) 272-5433

1445 Health Center Pkwy
Yukon, OK 73099
Phone (405) 577-6701

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 4

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1649290594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N SHARTEL AVE STE 1006",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032433",
            "telephone_number": "405-546-7699",
            "fax_number": "405-546-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N SHARTEL AVE STE 1006",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032433",
            "telephone_number": "405-546-7699",
            "fax_number": "405-546-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "M.D., F.A.C.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "17633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256940A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.