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1811144124

NPI Code Detail

MEDICARE: DR. MOHAMMAD MOUSSAVI MD

MEDICARE: DR. MOHAMMAD MOUSSAVI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	290694-1	NY
2	2084N0400X	Neurology Physician	V7756	TX
3	2084V0102X	Vascular Neurology Physician	42648	OK
4	2084A2900X	Neurocritical Care Physician	V7756	TX
5	2084V0102X	Vascular Neurology Physician	V7756	TX
6	2084V0102X	Vascular Neurology Physician	25MA08607400	NJ
7	2084N0400X	Neurology Physician	25MA08607400	NJ
8	2084V0102X	Vascular Neurology Physician	290694-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811144124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD MOUSSAVI MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE STE 1400
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3331
Country	:	US
Telephone Number	:	888-247-0125
Fax Number	:	918-502-8210

Provider Business Practice Location Address
First Line	:	6475 S YALE AVE STE 308
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7802
Country	:	US
Telephone Number	:	918-499-4000
Fax Number	:	918-499-4001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	09/26/2025

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Directions to “ DR. MOHAMMAD MOUSSAVI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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