Individual provider Active NPI

Gennady Slobodov, MD

  • Urology Physician
  • Oklahoma City, OK
National Provider Identifier
1932177185
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
21955 Issued in OK
Practice address
825 NE 10TH St
Oupb5400
Oklahoma City, OK 73104-5417
Phone
(405) 271-6452
NPI assigned
Mar 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 21955 OK Primary

Addresses

Primary practice location

825 NE 10TH St
Oupb5400
Oklahoma City, OK 73104-5417

Mailing address

1122 NE 13TH St
Ori236
Oklahoma City, OK 73117-1039

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
I20050815000470 OK Practitioner - Urology 8224072632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Oklahoma College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Memorial Health Hospital, Lawton, OK, CCN 370056

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21955OKMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2005 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2005 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

825 NE 10th St
#5400
Oklahoma City, OK 73104
Phone (405) 271-6452

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

825 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-1500

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

825 NE 10th St
Ste 5F
Oklahoma City, OK 73104
Phone (405) 271-6452

Interoperability endpoints

  • Direct secure messaging: gslobodov22327@ouhealth.direct-ci.net

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 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": "1142121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1932177185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 10TH ST",
            "address_2": "OUPB5400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045417",
            "telephone_number": "405-271-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOBODOV",
        "first_name": "GENNADY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-12",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "21955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.