Organization Active NPI

Galen Inpatient Physicians, PC

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1063456283
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GALEN INPATIENT PHYSICIANS, PC
Practice address
225 N Jackson Ave
San Jose, CA 95116-1603
Phone
(408) 378-6131
NPI assigned
Jun 16, 2006
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Theophile Koury, PRESIDENT
Title
M.D
Phone
(510) 350-2644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

225 N Jackson Ave
San Jose, CA 95116-1603

Mailing address

2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2644

Other identifiers 1

IdentifierTypeStateIssuer
GR0093523MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322000680 CA Part B Supplier - Clinic/Group Practice 3678464633 Receives reassigned benefits from 977 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Oxnard, CA; Redding, CA; Roseville, CA; Saint Helena, CA; San Luis Obispo, CA; Selma, CA; Simi Valley, CA; Sonora, CA…
O20140702002722 OR Part B Supplier - Clinic/Group Practice 3678464633 Receives reassigned benefits from 47 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Roseburg, OR; Tillamook, OR

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1063456283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-378-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALEN INPATIENT PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "510-350-2644",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093523",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.