Active NPI
Somphanh Tynoi Khousakoun, D.O.
- Neurology Physician
- Clearwater, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- OS14703
- Practice address
- 501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964 - Phone
- (727) 498-0808
- Fax
- (727) 477-8303
- NPI assigned
- Apr 15, 2013
- Last updated
- Jul 29, 2025
- 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 | OS14703 | FL | Primary |
Addresses
Primary practice location
501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964
Mailing address
501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964
Phone (727) 498-0808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022915800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of New England, College of Osteo Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
501 S Lincoln Ave
Clearwater, FL 33756-5964
Phone (727) 498-0808
Hospital & facility affiliations
- Haven Home Health Care
- Morton Plant Hospital
- Mease Countryside Hospital
- Adventhealth North Pinellas
- St Josephs Hospital
- St Anthonys Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 60 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS14703 | FL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Bay Neurocognitive Institute PLLC | Neurology | Current | Accepting new patients |
Locations
1433 Gulf To Bay Blvd
Ste F
Clearwater, FL 33755
Phone (727) 498-0808
501 S Lincoln Ave
Ste 26
Clearwater, FL 33756
Phone (727) 442-2193
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJIEDD
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tampa Bay Neurocognitive Institute
- Neurology Physician
- Clearwater, FL
- NPI 1730926304
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Morton Plant Hospital
- General Acute Care Hospital
- Clearwater, FL
- NPI 1376529743
-
dba St. Anthonys Hospital
- General Acute Care Hospital
- St Petersburg, FL
- NPI 1427024942
-
dba St. Joseph's Women's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
-
dba AdventHealth North Pinellas
- General Acute Care Hospital
- Tarpon Springs, FL
- NPI 1568473015
-
dba Mease Countryside Hospital
- General Acute Care Hospital
- Clearwater, FL
- NPI 1265419907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1205279759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S LINCOLN AVE STE 26",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337565964",
"telephone_number": "727-498-0808",
"fax_number": "727-477-8303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S LINCOLN AVE STE 26",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337565964",
"telephone_number": "727-498-0808",
"fax_number": "727-477-8303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOUSAKOUN",
"first_name": "SOMPHANH",
"middle_name": "TYNOI",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-15",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "OS14703",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022915800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.