Individual provider Active NPI

Nabil Elias Srouji, MD

  • Ophthalmology Physician
  • Oklahoma City, OK
National Provider Identifier
1811071400
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
17285 Issued in OK
Practice address
3520 NW 58TH St Ste A100
Oklahoma City, OK 73112-4407
Phone
(405) 443-3350
Fax
(405) 443-3341
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 17285 OK Primary

Addresses

Primary practice location

3520 NW 58TH St Ste A100
Oklahoma City, OK 73112-4407

Mailing address

3520 NW 58TH St Ste A100
Oklahoma City, OK 73112-4407
Phone (405) 443-3350

Other identifiers 5

IdentifierTypeStateIssuer
2415060002OtherCIGNA
5652035OtherAETNA
743149856OtherUNITED HEALTHCARE
VP11765OtherBLUE LINCS
100137580AMedicaidOK

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000047 OK Practitioner - Ophthalmology 5890729974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Oklahoma College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3520 NW 58TH St
Suite A100
Oklahoma City, OK 73112-4437
Phone (405) 443-3350

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17285OKMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Retina PLLC Ophthalmology CurrentSince Apr 1, 2005 Accepting new patients

Locations

3520 NW 58th St
Ste A100
Oklahoma City, OK 73112
Phone (405) 443-3350

3435 NW 56th St
Ste 808
Oklahoma City, OK 73112
Phone (405) 945-4848

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1811071400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 NW 58TH ST STE A100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124407",
            "telephone_number": "405-443-3350",
            "fax_number": "405-443-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 NW 58TH ST STE A100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124407",
            "telephone_number": "405-443-3350",
            "fax_number": "405-443-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUJI",
        "first_name": "NABIL",
        "middle_name": "ELIAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "17285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2415060002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5652035",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "743149856",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE LINCS",
            "identifier": "VP11765",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100137580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.