Individual provider Active NPI

Mohd Omar Qutob, M.D

  • Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1679952584
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
31642 Issued in OK
Practice address
920 Stanton L Young Blvd # Wp2140
Oklahoma City, OK 73104-5036
Phone
(405) 271-7912
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 31642 OK Primary

Addresses

Primary practice location

920 Stanton L Young Blvd # Wp2140
Oklahoma City, OK 73104-5036

Mailing address

700 NE 13TH St # 38
Oklahoma City, OK 73104-5004
Phone (405) 764-8066

Other practice location 1

1919 S Wheeling Ave Ste 600
Tulsa, OK 74104-5635
Phone (918) 619-4400

Other identifiers 1

IdentifierTypeStateIssuer
200600440BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 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
I20210323002813 OK Practitioner - General SurgeryPractitioner - Surgical Oncology 0244533842 Reassigns benefits to 6 organizations
I20230930000432 TX Practitioner - General Surgery 0244533842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

10900 Hefner Pointe Dr
Suite 505
Oklahoma City, OK 73120-5006
Phone (405) 936-1180

13100 N Western Ave
Suite 200
Oklahoma City, OK 73114-1431
Phone (405) 208-9097

800 NE 10TH St
Ouhp Stephenson Cancer Center
Oklahoma City, OK 73104-5418
Phone (405) 271-1112

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

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Nov 15, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Nov 26, 2020 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Aug 15, 2023 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Aug 15, 2023 Accepting new patients
Premier Wound Care PLLC Surgery CurrentSince Aug 1, 2025 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Sep 30, 2023 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Aug 15, 2023 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Nov 26, 2020 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

700 NE 13th St
#38
Oklahoma City, OK 73104

13100 N Western Ave
Ste 200
Oklahoma City, OK 73114
Phone (405) 208-9097

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

10900 Hefner Pointe Dr
Ste 505
Oklahoma City, OK 73120
Phone (405) 552-0400

920 Stanton L Young Blvd
Oklahoma City, OK 73104
Phone (405) 271-5251

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

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

920 Stanton L Young Blvd
#2140
Oklahoma City, OK 73104
Phone (405) 271-6308

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

Dept 1467
Tulsa, OK 74182

1919 S Wheeling Ave
Ste 600
Tulsa, OK 74104
Phone (918) 634-7500

591 E 36th St N
Tulsa, OK 74106
Phone (918) 619-8700

Dept 1038
Tulsa, OK 74182

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

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 and National Provider Directory roles.

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1679952584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 13TH ST # 38",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045004",
            "telephone_number": "405-764-8066",
            "fax_number": "405-271-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD # WP2140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-7912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 S Wheeling Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045635",
            "country_code": "US",
            "telephone_number": "918-619-4400",
            "fax_number": "918-634-7560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUTOB",
        "first_name": "MOHD",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "31642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200600440B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.