NPIMap

Individual provider Active NPI

Gautam Dehadrai, MD

  • Diagnostic Radiology Physician
  • Norman, OK
National Provider Identifier
1982653424
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2003-0258 Issued in NM
Practice address
901 N Porter Ave
Norman, OK 73071-6404
Phone
(405) 307-1600
Fax
(405) 307-1604
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2003-0258 NM Primary

Addresses

Primary practice location

901 N Porter Ave
Norman, OK 73071-6404

Mailing address

PO Box 1308
Attention: Managed Care
Norman, OK 73070-1308
Phone (405) 307-1600

Other identifiers 1

IdentifierTypeStateIssuer
200050770AMedicaidOK

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
I20061006000589 OK Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2264338318 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NRHS Radiology AssociatesGroup PAC ID 2668555731, 61 clinicians
Oklahoma Prostate Imaging LLCGroup PAC ID 5193174761, 2 clinicians

Practice addresses (Care Compare)

3300 Healthplex Pkwy
Norman, OK 73072-9749
Phone (405) 515-1000

8516 S Portland Ave
Oklahoma City, OK 73159-6477
Phone (405) 778-3141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
88.72
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-0258NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Vascular and Embolization Center by Flex Medical Group CurrentSince Apr 9, 2024 Accepting new patients
Mara Vascular & Interventional Radiology of Okc LLC CurrentSince Oct 1, 2022 Accepting new patients
Oklahoma Prostate Imaging, LLC CurrentSince Dec 1, 2023 Accepting new patients
NRHS Radiology Associates Diagnostic Radiology CurrentSince Nov 1, 2007 Accepting new patients
Unm Medical Group Inc Past Accepting new patients

Locations

700 S Telephone Rd
Moore, OK 73160
Phone (405) 793-9355

701 E Robinson St
Ste 102
Norman, OK 73071
Phone (405) 928-2900

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

1145 W I 240 Service Rd
Ste F100
Oklahoma City, OK 73139
Phone (405) 898-9048

5400 N Grand Blvd
Ste 260
Oklahoma City, OK 73112
Phone (405) 486-7250

8324 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 473-6866

13700 S Western Ave
Ste 100
Oklahoma City, OK 73170
Phone (405) 669-3569

Organizations & group practices 5

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 5

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1982653424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1308",
            "address_2": "ATTENTION: MANAGED CARE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730701308",
            "telephone_number": "405-307-1600",
            "fax_number": "405-307-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716404",
            "telephone_number": "405-307-1600",
            "fax_number": "405-307-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHADRAI",
        "first_name": "GAUTAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "2003-0258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200050770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.