Individual provider Active NPI

Prakash Poudel Jaishi, MD

  • Pediatric Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1679251383
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
47822 Issued in OK
Practice address
1200 Childrens Ave Ste 14601
Oklahoma City, OK 73104-4637
Phone
(405) 271-8001
Fax
(405) 271-5535
NPI assigned
Jul 11, 2023
Reactivated
Dec 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 47822 OK Primary

Addresses

Primary practice location

1200 Childrens Ave Ste 14601
Oklahoma City, OK 73104-4637

Mailing address

1955 1St Ave Apt 301
New York, NY 10029-6440
Phone (972) 854-1502

Other practice location 1

1901 First Avenue 5th Floor Metropolitan Hospital
Center Department of Pediatrics
New York, NY 10029
Phone (972) 854-1502 ext. 1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47822OKMDPediatric Gastroenterology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1679251383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 1ST AVE APT 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296440",
            "telephone_number": "972-854-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 14601",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-8001",
            "fax_number": "405-271-5535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 First Avenue 5th Floor Metropolitan Hospital",
            "address_2": "Center Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "972-854-1502 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POUDEL JAISHI",
        "first_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "deactivation_date": "2024-02-16",
        "reactivation_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OK",
            "license": "47822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.