Active NPI
Behrooz Mahmoodjanloo
- Durable Medical Equipment & Medical Supplies
- Edmond, OK
National Provider Identifier
1790257970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 1713 W 33Rd St
Edmond, OK 73013-3839 - Phone
- (405) 826-9255
- NPI assigned
- Dec 27, 2018
- Last updated
- Dec 27, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | OK | Primary |
Addresses
Primary practice location
1713 W 33Rd St
Edmond, OK 73013-3839
Mailing address
1713 W 33Rd St
Edmond, OK 73013-3839
Phone (405) 826-9255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 743689122 | Medicaid | OK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545868800000",
"number": "1790257970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 W 33RD ST",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133839",
"telephone_number": "405-826-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 W 33RD ST",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133839",
"telephone_number": "405-826-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHMOODJANLOO",
"first_name": "BEHROOZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-27",
"last_updated": "2018-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "OK",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "743689122",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.