Individual provider Active NPI

Siavash Nael, M.D.

  • Behavioral Neurology & Neuropsychiatry Physician
  • Oklahoma City, OK
National Provider Identifier
1902809353
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
License
12064 Issued in OK
Practice address
4720 S Western Ave
Oklahoma City, OK 73109
Phone
(405) 634-5529
Fax
(405) 636-1673
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 12064 OK Primary

Addresses

Primary practice location

4720 S Western Ave
Oklahoma City, OK 73109

Mailing address

4720 S Western Ave
Oklahoma City, OK 73109-3834
Phone (405) 634-5529

Other identifiers 2

IdentifierTypeStateIssuer
731186241OtherOKTAX ID UNDER GROUP
100038930AMedicaidOK

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
I20110404000351 OK Practitioner - NeuropsychiatryPractitioner - PsychiatryPractitioner - Pain Management 6103815113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeuropsychiatryAlso: Pain Management, Psychiatry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Absentee Shawnee Tribal Health Authority, IncGroup PAC ID 5799171088, 83 clinicians

Practice addresses (Care Compare)

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12064OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Absentee Shawnee Tribal Health Authority, Inc. CurrentSince May 31, 2022 Accepting new patients
Absentee Shawnee Tribal Health Authority, Inc. Current Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

15702 E State Highway 9
Norman, OK 73026
Phone (405) 447-0300

15951 Little Axe Dr
Norman, OK 73026
Phone (405) 447-0300

2029 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 878-4702

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1902809353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093834",
            "telephone_number": "405-634-5529",
            "fax_number": "405-636-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73109",
            "telephone_number": "405-634-5529",
            "fax_number": "405-636-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAEL",
        "first_name": "SIAVASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "OK",
            "license": "12064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID UNDER GROUP",
            "identifier": "731186241",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100038930A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.