Active NPI
Mokhtar Boukhari, DO
- Neurology Physician
- Henderson, NV
National Provider Identifier
1043716962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- DO3055
- Practice address
- 10001 S Eastern Ave Ste 200
Henderson, NV 89052-3908 - Phone
- (702) 790-1521
- NPI assigned
- Mar 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | DO3055 | NV | Primary |
Addresses
Primary practice location
10001 S Eastern Ave Ste 200
Henderson, NV 89052-3908
Mailing address
PO Box 96064
Las Vegas, NV 89193-6064
Phone (702) 790-1521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043716962 | Medicaid | NV | |
| DO3055 | Other | NV | NV STATE BOARD OF OSTEOPATHIC MEDICINE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230120002287 | AZ | Practitioner - Neurology | 9739578626 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Western Un of HLTH Sciences, Col of Podiatric Med, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Honorhealth Ambulatory
Practice addresses (Care Compare)
19841 N 27TH Ave
Suite 101
Phoenix, AZ 85027-4004
Phone (602) 861-1168
Hospital & facility affiliations
- Honorhealth Deer Valley Medical Center
- Honorhealth Sonoran Crossing Medical Center
- Honorhealth Scottsdale Osborn Medical Center
- Honor Health John C. Lincoln Medical Center
- Honorhealth Scottsdale Shea Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO3055 | NV | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honorhealth Ambulatory | Current | Accepting new patients | |
| Honorhealth Ambulatory | Current | Accepting new patients | |
| Honorhealth Ambulatory | Current | Accepting new patients |
Locations
19841 N 27th Ave
Ste 101
Phoenix, AZ 85027
Phone (602) 439-1111
2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462
10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250
Organizations & group practices 3
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.
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Hospital & facility affiliations 5
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": "1522368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1043716962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 96064",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891936064",
"telephone_number": "702-790-1521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10001 S EASTERN AVE STE 200",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523908",
"telephone_number": "702-790-1521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUKHARI",
"first_name": "MOKHTAR",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-30",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NV",
"license": "DO3055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043716962",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NV STATE BOARD OF OSTEOPATHIC MEDICINE",
"identifier": "DO3055",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.