Khosrow Vakhshouri, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A87152 Issued in CA

Practice address

2151 W Grant Line Rd
Tracy, CA 95377-7309

Phone

(209) 832-0535

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Salida, CA, CCN 057695
• Sutter Tracy Community Hospital Hospital, Tracy, CA, CCN 050313
• Memorial Medical Center Hospital, Modesto, CA, CCN 050557
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvakhshouri58454@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sutter North Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)
• Sutter Tracy Community Hospital

  • General Acute Care Hospital
  • Tracy, CA
  • NPI 1043291164
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1699129601
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Tracy, CA
  • NPI 1821442864
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Salida, CA
  • NPI 1972876506
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1215993456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W GRANT LINE RD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777309",
            "telephone_number": "209-832-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKHSHOURI",
        "first_name": "KHOSROW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87152",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A871520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Uribe
• Jordan M Usunov, MD
• Gianna Utzerath
• Alan Tadao Uyeno, MD
• VA Palo Altohealth Care Systems Facility
• Adrian Valadez
• Kenia Valdez-Ramirez
• Alize Valdez
• Lissette Valencia Leon
• Adriana Valencia

• Family Medicine Physician in Tracy, CA
• Providers in Tracy, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.

Verify at the official NPI Registry.