NPIMap

Individual provider Active NPI

Wissam J Khoory, M.D.

  • Internal Medicine Physician
  • Waltham, MA
National Provider Identifier
1013962430
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
153969 Issued in MA
Practice address
20 Hope Ave
Suite G03
Waltham, MA 02453-2721
Phone
(781) 893-4490
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 153969 MA Primary

Addresses

Primary practice location

20 Hope Ave
Suite G03
Waltham, MA 02453-2721

Mailing address

20 Hope Ave
Suite. G03
Waltham, MA 02453-2721
Phone (781) 893-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101020000826 MA Practitioner - Internal Medicine 7911190111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 Hope Ave
Suite G03
Waltham, MA 02453-2717
Phone (781) 893-4490

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Elara Caring Home health agency, Braintree, MA, CCN 227475
  • Bayada Home Health Care, Inc Home health agency, Canton, MA, CCN 227551
  • Good Shepherd Community Care Hospice, Newton, MA, CCN 221500
  • Care Dimensions, Inc Hospice, Danvers, MA, CCN 221522
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153969MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wissam Khoory, MD,PC Internal Medicine CurrentSince Jun 24, 2010 Accepting new patients

Locations

20 Hope Ave
Ste G03
Waltham, MA 02453
Phone (781) 893-4490

Interoperability endpoints

  • Direct secure messaging: khoory.wissam.wjk@direct.partners.masshiway.net

Organizations & group practices 1

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 12

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1013962430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOPE AVE",
            "address_2": "SUITE. G03",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532721",
            "telephone_number": "781-893-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOPE AVE",
            "address_2": "SUITE G03",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532721",
            "telephone_number": "781-893-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOORY",
        "first_name": "WISSAM",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "153969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.