Individual provider Active NPI

Michael Nakmali, PA

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1780226860
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3162 Issued in OK
Practice address
6100 S Yale Ave
Tulsa, OK 74136-1923
Phone
(918) 494-0612
NPI assigned
Oct 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 3162 OK Primary

Addresses

Primary practice location

6100 S Yale Ave
Tulsa, OK 74136-1923

Mailing address

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 494-0612

Other practice location 1

2033 NW 21st St
Oklahoma City, OK 73106-1613
Phone (405) 370-4793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241226002800 CA Practitioner - Physician Assistant 5395272645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Pain Specialists of Southern California IncGroup PAC ID 3577669860, 2 clinicians

Practice addresses (Care Compare)

7525 Linda Vista Rd
Suite C
San Diego, CA 92111-5344
Phone (619) 398-2988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3162OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, Inc. Single Specialty PastSince Nov 29, 2020 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": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1780226860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-494-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361923",
            "telephone_number": "918-494-0612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2033 NW 21st St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731061613",
            "country_code": "US",
            "telephone_number": "405-370-4793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAKMALI",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.