Khusboo Surtani, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17609 Issued in TX

Practice address

12410 Toepperwein Rd
Live Oak, TX 78233-3230

Phone

(210) 742-6555

NPI assigned

Aug 22, 2019

Reactivated

Feb 9, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486
  Medicare reassignment NPD
• Hillside Primary Care PLLC

  • Internal Medicine Physician
  • Live Oak, TX
  • NPI 1205349040
  Medicare reassignment
• Wellmed Medical Group, P.a.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD
• Heal Well Primary Care PC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1003518473
  NPD
• Complete Care Partners LLC

  • Family Medicine Physician
  • El Paso, TX
  • NPI 1114437563
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1023665221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURTANI",
        "first_name": "KHUSBOO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "deactivation_date": "2024-01-08",
        "reactivation_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA17609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy N. Stoll, M.D.
• Caroline Beth Stray
• Strickland Anesthesia Services, PLLC
• Alexis Sturgis
• Surgical Eye Center of San Antonio
• Moiz Abbas Tajkhanji, M.D.
• David Wayne Talafuse, M.D.
• Muhammad Talib, MD
• David R Talley, MD
• Douglas A Taylor, CP

• Medical Physician Assistant in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.