Individual provider Active NPI

Mutasim Mohamed Eltigani Idriss, MD

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1760168157
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
50405 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 502-1900
Fax
(918) 494-6303
NPI assigned
Jun 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 50405 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6502 S Yale Ave Ste 3410
Tulsa, OK 74136-8342
Phone (918) 499-4855

Other practice location 1

10501 E 91st St
Tulsa, OK 74133-5790
Phone (918) 502-1900

Other practice location 2

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 502-1900

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital PastSince Jun 25, 2023 Accepting new patients
The Unity Hospital of Rochester PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1760168157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 S YALE AVE STE 3410",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368342",
            "telephone_number": "918-499-4855",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-502-1900",
            "fax_number": "918-494-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10501 E 91st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741335790",
            "country_code": "US",
            "telephone_number": "918-502-1900",
            "fax_number": "918-494-6303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Rockefeller Dr",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744015075",
            "country_code": "US",
            "telephone_number": "918-502-1900",
            "fax_number": "918-494-6303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDRISS",
        "first_name": "MUTASIM",
        "middle_name": "MOHAMED ELTIGANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "50405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.