NPIMap

Individual provider Active NPI

Reza John Azadi, D.O.

  • Nephrology Physician
  • Tulsa, OK
National Provider Identifier
1932300472
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4270 Issued in OK
Practice address
6465 S Yale Ave Ste 804
Tulsa, OK 74136-7810
Phone
(918) 502-3550
Fax
(918) 502-3555
NPI assigned
May 31, 2007
Last updated
Apr 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4270 OK Primary

Addresses

Primary practice location

6465 S Yale Ave Ste 804
Tulsa, OK 74136-7810

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125

Other practice location 1

2605 W Main St
Jenks, OK 74037
Phone (918) 209-4550

Other identifiers 1

IdentifierTypeStateIssuer
200181090AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000487 OK Practitioner - Nephrology 3072663111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Oklahoma State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4270OKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Feb 14, 2019 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Saint Francis Outreach Services LLC Past Accepting new patients

Locations

2605 W Main St
Jenks, OK 74037
Phone (918) 298-2336

10507 E 91st St
Ste 110
Tulsa, OK 74133
Phone (918) 502-1715

6465 S Yale Ave
Ste 804
Tulsa, OK 74136
Phone (918) 502-3550

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: razadi50671@direct.saintfrancis.com
  • Direct secure messaging: reza.azadi@direct.stjohnhealthsystem.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1932300472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0125",
            "fax_number": "918-502-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 804",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367810",
            "telephone_number": "918-502-3550",
            "fax_number": "918-502-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 W Main St",
            "address_purpose": "LOCATION",
            "city": "Jenks",
            "state": "OK",
            "postal_code": "74037",
            "country_code": "US",
            "telephone_number": "918-209-4550",
            "fax_number": "918-298-7866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZADI",
        "first_name": "REZA",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "4270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200181090A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.