Active NPI
Nidhi Koul, M.D.
- Pediatrics Physician
- Broken Arrow, OK
National Provider Identifier
1861587289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 224299
- Practice address
- 2617 S. Elm Place
Broken Arrow, OK 74012-7850 - Phone
- (918) 455-6980
- Fax
- (918) 449-9749
- NPI assigned
- Oct 3, 2006
- Last updated
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 224299 | MA | Primary |
Addresses
Primary practice location
2617 S. Elm Place
Broken Arrow, OK 74012-7850
Mailing address
2617 S. Elm Place
Broken Arrow, OK 74012-7850
Phone (918) 455-6980
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000031938 | Other | MA | BMC HEALTHNET PLAN |
| 3986470 | Other | MA | AETNA |
| 89793 | Other | MA | CMSP |
| 412987 | Other | RI | BC BS OF RI |
| AA40070 | Other | MA | HARVARD PILGRIM |
| 0036582 | Other | MA | NHP |
| 1300172 | Medicaid | MA | |
| 200222490A | Medicaid | OK | |
| 486892 | Other | MA | TUFTS |
| J29428 | Other | MA | BC BS OF MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Hospital, Inc. | Past | Accepting new patients | |
| St John Medical Center Inc | Past | Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Pediatrics | Past | Accepting new patients |
| Saint Francis Hospital South LLC | Past | Accepting new patients | |
| Southcoast Hospitals Group Inc | Past | Accepting new patients | |
| Ahs Southcrest Hospital, LLC | Past | Accepting new patients | |
| Healthfirst Family Care Center Inc. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Utica Park Clinic
- Family Medicine Physician
- Tulsa, OK
- NPI 1235182775
Pediatrics
-
dba HIllcrest Hospital South
- General Acute Care Hospital
- Tulsa, OK
- NPI 1750661534
-
dba Saint Francis Hospital South
- General Acute Care Hospital
- Tulsa, OK
- NPI 1376561944
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1144228487
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1154417368
-
- Federally Qualified Health Center (FQHC)
- Fall River, MA
- NPI 1962435933
Pediatrics
-
dba Southcoast Pharmacy
- Community/Retail Pharmacy
- New Bedford, MA
- NPI 1376565366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1861587289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2617 S. ELM PLACE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740127850",
"telephone_number": "918-455-6980",
"fax_number": "918-449-9749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2617 S. ELM PLACE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740127850",
"telephone_number": "918-455-6980",
"fax_number": "918-449-9749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUL",
"first_name": "NIDHI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "224299",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTHNET PLAN",
"identifier": "000000031938",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3986470",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMSP",
"identifier": "89793",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF RI",
"identifier": "412987",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "AA40070",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "0036582",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1300172",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200222490A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "486892",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF MA",
"identifier": "J29428",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.