Haresh Kantilal Ajmera, MD

Individual provider Active NPI Gastroenterology Physician · Tulsa, OK

NPI 1780747261 · NPPES record last updated Jan 11, 2017

Key facts

NPI
1780747261
Entity type
Individual (NPI type 1)
Primary specialty
Gastroenterology Physician 207RG0100X
License
10644 (OK)
Practice address
1145 S Utica Ave
Suite 500
Tulsa, OK 74104-4014
Phone
(918) 744-8115
Fax
(918) 744-8117
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070220000487 OK Practitioner - Gastroenterology
Practitioner - Internal Medicine
8921100025 Practice locations: Tulsa, OK

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Haresh K Ajmera MD Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 10644 OK Yes

Addresses

Primary practice location

1145 S Utica Ave
Suite 500
Tulsa, OK 74104-4014

Mailing address

1145 S Utica Ave
Suite 500
Tulsa, OK 74104-4014
Phone (918) 744-8115

Other providers in Tulsa, OK

All providers in Tulsa, OK · Gastroenterology Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.