Individual provider Active NPI

Bill J. Khoury, M.D.

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1003868027
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A63305 Issued in CA
Practice address
1818 Verdugo Blvd
Ste 302
Glendale, CA 91208-1442
Phone
(818) 928-9373
Fax
(818) 301-2048
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A63305 CA
Emergency Medicine Physician 207P00000X A63305 CA Primary

Addresses

Primary practice location

1818 Verdugo Blvd
Ste 302
Glendale, CA 91208-1442

Mailing address

1818 Verdugo Blvd
Ste 302
Glendale, CA 91208-1442
Phone (818) 928-9373

Other identifiers 1

IdentifierTypeStateIssuer
1003868027MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000528 CA Practitioner - Emergency MedicinePractitioner - General PracticePractitioner - Undersea and Hyperbaric Medicine 7810927399 Reassigns benefits to 2 organizations
Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Practice, Undersea and Hyperbaric Medicine
Education
Loma Linda University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medamerica Physician Solutions PCGroup PAC ID 8729221809, 28 clinicians
Cep America - Auc PCGroup PAC ID 9537481692, 26 clinicians

Practice addresses (Care Compare)

16 E Fern Ave
Suite B
Redlands, CA 92373-4000
Phone (909) 435-4852

26137 La Paz Rd
Suite 120
Mission Viejo, CA 92691-5329
Phone (949) 452-3309

Hospital & facility affiliations

  • Hoag Home Health Home health agency, Newport Beach, CA, CCN 557412
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue630
Removal of skin lesions27
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63305CAMDClinical Social Worker
A63305CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Podiatry Group a Prof Corp CurrentSince Nov 20, 2021 Accepting new patients
Medamerica Physician Solutions PC Emergency Medicine CurrentSince Nov 20, 2021 Accepting new patients
Cep America - Auc PC General Practice CurrentSince Sep 1, 2014 Accepting new patients
Cep America - Auc, PC CurrentSince Sep 1, 2014 Accepting new patients
Cep America - Auc PC General Practice Current Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Bear Valley Community Health Care District Past Accepting new patients
California Emergency Physician Medical Group General Practice Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

22855 Lake Forest Dr
Ste A
Lake Forest, CA 92630
Phone (949) 452-7544

26732 Crown Valley Pkwy
Ste 585
Mission Viejo, CA 92691
Phone (949) 645-3333

23962 Alicia Pkwy
Ste I1
Mission Viejo, CA 92691
Phone (949) 297-0238

26137 La Paz Rd
Ste 120
Mission Viejo, CA 92691
Phone (949) 452-3309

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

16 E Fern Ave
Ste B
Redlands, CA 92373
Phone (909) 435-4852

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bill.khoury.1@20515.direct.athenahealth.com

Organizations & group practices 8

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 4

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1003868027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "STE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081442",
            "telephone_number": "818-928-9373",
            "fax_number": "818-301-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "STE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081442",
            "telephone_number": "818-928-9373",
            "fax_number": "818-301-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "BILL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A63305",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A63305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003868027",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.