Active NPI
Nabil Kaddis Bissada, M.D.
- Urology Physician
- Oklahoma City, OK
National Provider Identifier
1932299500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 29007
- Practice address
- 825 N.E. 10TH Street
Suite 5400
Oklahoma City, OK 73104 - Phone
- (405) 271-6452
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | R-2121 | AR | |
| Urology Physician | 208800000X | 29007 | OK | Primary |
Addresses
Primary practice location
825 N.E. 10TH Street
Suite 5400
Oklahoma City, OK 73104
Mailing address
920 Stanton L. Young Boulevard
Wp3150
Oklahoma City, OK 73104
Phone (405) 271-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148787001 | Medicaid | AR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13661 | SC | MD | Social Worker |
| 29007 | OK | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1932299500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 STANTON L. YOUNG BOULEVARD",
"address_2": "WP3150",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73104",
"telephone_number": "405-271-6900",
"fax_number": "405-271-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 N.E. 10TH STREET",
"address_2": "SUITE 5400",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73104",
"telephone_number": "405-271-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISSADA",
"first_name": "NABIL",
"middle_name": "KADDIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "AR",
"license": "R-2121",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OK",
"license": "29007",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "148787001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.