Individual provider Active NPI

Juvy M Khouzam, MD

  • Anesthesiology Physician
  • Dayton, OH
National Provider Identifier
1225019888
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35084318 Issued in OH
Practice address
1 Wyoming Street
Dayton, OH 45409-2722
Phone
(937) 208-6173
Fax
(937) 208-3843
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35084318 OH Primary

Addresses

Primary practice location

1 Wyoming Street
Dayton, OH 45409-2722

Mailing address

PO Box 632317
Cincinnati, OH 45263-2317
Phone (937) 208-6173

Other identifiers 1

IdentifierTypeStateIssuer
2530585MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050105000324 OH Practitioner - Anesthesiology 6204884463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

200 Medical Ctr Dr
Middletown, OH 45005-5200
Phone (513) 424-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35084318OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Services Network LTD Anesthesiology CurrentSince Dec 6, 2004 Accepting new patients
PHS Anesthesia Billing, LLC Anesthesiology CurrentSince Apr 30, 2025 Accepting new patients

Locations

1 Wyoming St
Ste 3027A
Dayton, OH 45409

6601 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 208-2111

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1 Wyoming St
Fl 3
Dayton, OH 45409
Phone (937) 208-2627

3484 Far Hills Ave
Kettering, OH 45429
Phone (937) 208-4380

200 Medical Center Dr
Middletown, OH 45005
Phone (937) 276-8320

Organizations & group practices 2

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 1

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1225019888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632317",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632317",
            "telephone_number": "937-208-6173",
            "fax_number": "937-208-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING STREET",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-6173",
            "fax_number": "937-208-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOUZAM",
        "first_name": "JUVY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35084318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2530585",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.