Individual provider Active NPI

Namir Katkhouda, MD

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1164450714
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A54640 Issued in CA
Practice address
1450 San Pablo St
Suite 6200
Los Angeles, CA 90033-4500
Phone
(323) 442-9062
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A54640 CA Primary

Addresses

Primary practice location

1450 San Pablo St
Suite 6200
Los Angeles, CA 90033-4500

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-9062

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address namir.katkhouda@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061019000654 CA Practitioner - General Surgery 7012913767 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54640CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Surgery CurrentSince Apr 1, 2009 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2009 Accepting new patients
Usc Surgeons, Inc. Surgery Past Accepting new patients

Locations

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1510 San Pablo St
Ste 514
Los Angeles, CA 90033
Phone (323) 442-5910

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1164450714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "address_2": "SUITE 6200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334500",
            "telephone_number": "323-442-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATKHOUDA",
        "first_name": "NAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A54640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "namir.katkhouda@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St",
            "address_2": "Suite 6200",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900334500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.