NPIMap

Individual provider Active NPI

Mahdi Mussa, M.D.

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1821229089
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28402 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 713-7403
Fax
(405) 713-2794
NPI assigned
Aug 5, 2009
Last updated
Jul 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP678 KY
Family Medicine Physician 207Q00000X 2008015412 MO
Family Medicine Physician 207Q00000X 28402 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (405) 713-7403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110922000478 OK Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 2264618842 Reassigns benefits to 3 organizations
I20161109000144 MO Practitioner - Family Practice 2264618842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady Memorial HospitalGroup PAC ID 0648175778, 47 clinicians
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

2220 W Iowa Ave
Professional Medical Services
Chickasha, OK 73018-2738
Phone (405) 224-2300

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008015412MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Family Medicine CurrentSince Nov 24, 2021 Accepting new patients
Ozarks Medical Center CurrentSince Oct 28, 2016 Accepting new patients
Ies HSP Oklahoma LLC CurrentSince May 27, 2024 Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Grady Memorial Hospital Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Ozarks Medical Center Family Medicine CurrentSince Oct 28, 2016 Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Grady Memorial Hospital Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients
Grady Memorial Hospital Past Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1821229089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-7403",
            "fax_number": "405-713-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-713-7403",
            "fax_number": "405-713-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSA",
        "first_name": "MAHDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-05",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP678",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008015412",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "28402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.