Individual provider Active NPI

Philip Khoury, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Bakersfield, CA
National Provider Identifier
1083926232
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
20A14690 Issued in CA
Practice address
3850 Riverlakes Dr Ste B
Bakersfield, CA 93312-6662
Phone
(661) 241-9330
NPI assigned
Jul 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5101018777 MI
Pain Medicine (Anesthesiology) Physician 207LP2900X 20A14690 CA Primary

Addresses

Primary practice location

3850 Riverlakes Dr Ste B
Bakersfield, CA 93312-6662

Mailing address

3975 Brookside Dr
Bloomfield Hills, MI 48302-1510
Phone (248) 459-0314

Other practice location 1

28521 Orchard Lake Road
Suite C
Farmington Hills, MI 48334-2951
Phone (248) 987-6190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150706001141 MI Practitioner - Anesthesiology 3173835188 Reassigns benefits to 3 organizations
I20160916002212 CA Practitioner - Pain ManagementPractitioner - Anesthesiology 3173835188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
William Carey University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelle Anesthesia Services IncGroup PAC ID 4688046774, 41 clinicians

Practice addresses (Care Compare)

2215 Truxtun Ave
Bakersfield, CA 93301-3602
Phone (661) 632-5504

3850 Riverlakes Dr
Suite B
Bakersfield, CA 93312-6662
Phone (661) 241-9330

Hospital & facility affiliations

  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455
  • Mercy Hospital Hospital, Bakersfield, CA, CCN 050295

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14690CAMDAcupuncturist
5101018777MIMDAnesthesiology Physician
20A14690CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Aug 1, 2015 Accepting new patients
University Pain Clinic Associates, PLLC Pain Medicine CurrentSince Jan 1, 2016 Accepting new patients
Acquisition Bell Hospital LLC Anesthesiology CurrentSince Aug 17, 2015 Accepting new patients
Acquisition Bell Hospital LLC CurrentSince Aug 17, 2015 Accepting new patients
Excelle Anesthesia Services, Inc. Anesthesiology CurrentSince Oct 31, 2024 Accepting new patients

Locations

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

4160 John R St
Ste 522
Detroit, MI 48201
Phone (313) 745-1293

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

Organizations & group practices 6

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 2

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": "1278201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1083926232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 BROOKSIDE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021510",
            "telephone_number": "248-459-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 RIVERLAKES DR STE B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933126662",
            "telephone_number": "661-241-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28521 Orchard Lake Road",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483342951",
            "country_code": "US",
            "telephone_number": "248-987-6190",
            "fax_number": "248-987-6193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-04",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101018777",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "20A14690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.