Individual provider Active NPI

Deborah Zayneb Mohamad Ali, M.D.

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1922428770
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30656 Issued in OK
Practice address
4444 E 41St St
Tulsa, OK 74135-2527
Phone
(918) 619-4400
Fax
(918) 619-4334
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30656 OK Primary

Addresses

Primary practice location

4444 E 41St St
Tulsa, OK 74135-2527

Mailing address

4502 E 41St St
Tulsa, OK 74135-2536
Phone (918) 619-4400

Other identifiers 1

IdentifierTypeStateIssuer
200597720AMedicaidOK

Other names 1

  • Miss Deborah Zayneb Mohamad Former name

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
I20170817000607 OK Practitioner - Pediatric Medicine 0446522080 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30656OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Aug 1, 2017 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

4444 E 41st St
Ste A
Tulsa, OK 74135
Phone (682) 303-0376

4444 E 41st St
Ste 2B
Tulsa, OK 74135

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

4444 E 41st St
Tulsa, OK 74135

4444 E 41st St
Fl 2
Tulsa, OK 74135
Phone (918) 619-4300

4502 E 41st St
Tulsa, OK 74135
Phone (918) 579-2367

Interoperability endpoints

  • Direct secure messaging: dmohamadali180257@ahs.direct-ci.com
  • Direct secure messaging: dmohamadali28324@ouhealth.direct-ci.net

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1922428770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-619-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352527",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMAD ALI",
        "first_name": "DEBORAH",
        "middle_name": "ZAYNEB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "30656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200597720A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MOHAMAD",
            "middle_name": "ZAYNEB",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.