Active NPI
Poorya Fazel, M.D.
- Interventional Cardiology Physician
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 30464
- Practice address
- 6151 S Yale Ave
Suite a-100
Tulsa, OK 74136-1907 - Phone
- (918) 494-8500
- Fax
- (918) 307-5578
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
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 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Addiction (Substance Use Disorder) Counselor
- Tahlequah, OK
- NPI 1689338519
Hospital
-
- General Acute Care Hospital
- Muskogee, OK
- NPI 1386188837
Hospital
-
- Medicare Defined Swing Bed Hospital Unit
- Vinita, OK
- NPI 1467902460
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- University of Oklahoma College of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Warren Clinic Inc
Practice addresses (Care Compare)
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000
715 N Foreman St
Vinita, OK 74301-1422
Phone (918) 256-8731
Hospital & facility affiliations
- Saint Francis Hospital, Inc
- Saint Francis Hospital South, LLC
- Saint Francis Hospital Muskogee
- Saint Francis Hospital Vinita, Inc
- Northeastern Health System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 22 |
| Pacemaker insertion or repair | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140808000363 | OK | Practitioner - Interventional Cardiology | 6709937303 | Reassigns benefits to 6 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA22180774308 | TX | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Clinic Inc | Current | Accepting new patients | |
| Saint Francis Hospital Muskogee Inc | Current | Accepting new patients | |
| Healthtexas-Med Provider | Internal Medicine | Past | Accepting new patients |
Locations
300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501
6655 S Yale Ave
Tulsa, OK 74136
Phone (918) 481-4000
6151 S Yale Ave
Ste 100A
Tulsa, OK 74136
Phone (918) 494-2100
6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200
6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125
10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000
6600 S Yale Ave
Ste 600
Tulsa, OK 74136
Phone (918) 491-5990
6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045
6151 S Yale Ave
Ste 100
Tulsa, OK 74136
Phone (918) 499-2000
735 N Foreman St
Vinita, OK 74301
Phone (918) 256-7551
Interoperability endpoints
- pfazel64080@direct.saintfrancis.com
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | N2495 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | AA22180774308 | TX | |
| Interventional Cardiology Physician | 207RI0011X | 30464 | OK | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
6151 S Yale Ave
Suite a-100
Tulsa, OK 74136-1907
Mailing address
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347
Phone (918) 488-6001
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207296902 | Medicaid | TX |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2019.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1790993483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 S YALE AVE",
"address_2": "SUITE 1400",
"city": "TULSA",
"state": "OK",
"postal_code": "741363347",
"telephone_number": "918-488-6001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6151 S YALE AVE",
"address_2": "SUITE A-100",
"city": "TULSA",
"state": "OK",
"postal_code": "741361907",
"telephone_number": "918-494-8500",
"fax_number": "918-307-5578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZEL",
"first_name": "POORYA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "N2495",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "AA22180774308",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "OK",
"license": "30464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207296902",
"state": "TX"
}
],
"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 Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.