ASHRAF MAHMOUD ABDELMONEM MOHAMED M.D.
NPI 1275705519
Pediatrics - Pediatric Hematology-Oncology in Tulsa, OK


Quality Rating: 89.44 out of 100 score

NPI Status: Active since March 27, 2008

Contact Information

6161 S YALE AVE
TULSA, OK
ZIP 74136
Phone: (918) 502-6720
Fax: (918) 502-6725

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  • Individual
  • Male
  • Pediatrics
  • Pediatric Hematology-Oncology
  • Accepts Insurance
  • PECOS Enrolled

About ASHRAF MOHAMED

This page provides the complete NPI Profile along with additional information for Ashraf Mohamed, a pediatrician established in Tulsa, Oklahoma with a medical specialization in Pediatrics, focusing in pediatric hematology-oncology . The healthcare provider is registered in the NPI registry with number 1275705519 assigned on March 2008. The practitioner's primary taxonomy code is 2080P0207X with license number 21491 (OK). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1275705519
Provider Name
ASHRAF MAHMOUD ABDELMONEM MOHAMED M.D.
Gender
Male
Entity Type
Individual
Location Address
6161 S YALE AVE TULSA, OK 74136
Location Phone
(918) 502-6720
Location Fax
(918) 502-6725
Mailing Address
6600 S YALE AVE SUITE 1400 TULSA, OK 74136
Mailing Phone
(918) 499-4855
Mailing Fax
(918) 502-6725
Is Sole Proprietor?
No
Enumeration Date
03-27-2008
Last Update Date
10-24-2024
Code Navigator

A pediatrician like Ashraf Mohamed is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics Pediatric Hematology-Oncology

Taxonomy Code
2080P0207X
Type
Allopathic & Osteopathic Physicians
License No.
21491
License State
OK
Taxonomy Description
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12080P0207XAllopathic & Osteopathic Physicians

Pediatrics
Pediatric Hematology-Oncology

R8242 (TX)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Ascension St. John Empower Silver - HMO
  • Ascension St. John Empower Silver Standardized - HMO
  • CommunityCare Bronze IH223 - HMO
  • CommunityCare Bronze IH224 - HMO
  • CommunityCare Catastrophic - HMO
  • CommunityCare Expanded Bronze Standardized - HMO
  • CommunityCare Gold IH221 - HMO
  • CommunityCare Gold L21 - HMO
  • CommunityCare Gold Standardized - HMO
  • CommunityCare Silver L21 - HMO
  • CommunityCare Silver SLIH223 - HMO
  • CommunityCare Silver Standardized - HMO
  • Saint Francis Expanded Bronze Standardized - HMO
  • Saint Francis Silver Standardized - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple PCP Saver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Ashraf Mohamed is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 89.44, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 89.44 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 75.85

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for ASHRAF MAHMOUD ABDELMONEM MOHAMED M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275705519, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 7 → 14 → 5 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 4 + 0 + 1 + 0 + 5 + 2 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1275705519.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Anesthesiology
6161 S YALE AVE
TULSA, OK 74136
Pediatrics
6161 S YALE AVE, CHUCC
TULSA, OK 74136
Internal Medicine
6161 S YALE AVE
TULSA, OK 74136
Internal Medicine
6161 S YALE AVE
TULSA, OK 74136
Surgery
6161 S YALE AVE
TULSA, OK 74136
Clinic/Center (Medical Specialty)
6161 S YALE AVE, ER DEPT.
TULSA, OK 74136
Emergency Medicine (Emergency Medical Services)
6161 S YALE AVE, ER DEPT
TULSA, OK 74136
Emergency Medicine
6161 S YALE AVE, ER DEPT
TULSA, OK 74136
Emergency Medicine
6161 S YALE AVE, ER DEPT
TULSA, OK 74136
Emergency Medicine
6161 S YALE AVE, ER DEPT
TULSA, OK 74136
Emergency Medicine
6161 S YALE AVE, ER DEPT
TULSA, OK 74136
Physician Assistant
6161 S YALE AVE, C/O SAINT FRANCIS HOSPITAL
TULSA, OK 74136
Nurse Anesthetist, Certified Registered
6161 S YALE AVE
TULSA, OK 74136
Clinical Nurse Specialist (Pediatrics)
6161 S YALE AVE
TULSA, OK 74136
Pediatrics (Pediatric Critical Care Medicine)
6161 S YALE AVE, PICU
TULSA, OK 74136
Pathology (Pediatric Pathology)
6161 S YALE AVE
TULSA, OK 74136
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
6161 S YALE AVE
TULSA, OK 74136
Dietitian, Registered
6161 S YALE AVE, SAINT FRANCIS HOSPITAL, NUTRITION DEPARTMENT
TULSA, OK 74136
Speech-Language Pathologist
6161 S YALE AVE
TULSA, OK 74136
Dietitian, Registered
6161 S YALE AVE
TULSA, OK 74136

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275705519, enumerated as an "individual" on March 27, 2008.

The provider is located at 6161 S YALE AVE TULSA, OK 74136 and the phone number is (918) 502-6720.

Pediatrics with taxonomy code 2080P0207X and a focus in Pediatric Hematology-Oncology.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Blue Cross. Please consult your insurance carrier or call the provider to verify.