Active NPI
Ayad Khourdaji, M.D.
- Urology Physician
- Lodi, CA
National Provider Identifier
1245594167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- A153658
- Practice address
- 830 S Ham LN Ste 26
Lodi, CA 95242-7510 - Phone
- (209) 368-6661
- Fax
- (209) 333-7655
- NPI assigned
- Jun 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | A153658 | CA | Primary |
Addresses
Primary practice location
830 S Ham LN Ste 26
Lodi, CA 95242-7510
Mailing address
830 S Ham LN Ste 26
Lodi, CA 95242-7510
Phone (209) 368-6661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Wayne State University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
830 S Ham LN
Suite 26
Lodi, CA 95242-7510
Phone (209) 368-6661
Hospital & facility affiliations
- Adventist Health Lodi Memorial
- Mark Twain Medical Center
- Sutter Amador Hospital
- Adventist Health Sonora
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A153658 | CA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Physicians Network | Urology | Current | Accepting new patients |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| University of Virginia Physicians Group | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Adventist Health Heart Institute-Ukiah | Past | Accepting new patients |
Locations
1530 E Chevy Chase Dr
Ste 110
Glendale, CA 91206
Phone (818) 265-5411
1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695
830 S Ham Ln
Ste 26
Lodi, CA 95242
Phone (209) 368-6661
1 Hospital Dr
Fl 2
Charlottesville, VA 22908
1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241
1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Hanford, CA
- NPI 1063718583
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Charlottesville, VA
- NPI 1033138250
-
- Physical Therapy Clinic/Center
- Paradise, CA
- NPI 1134092190
-
- Urology Physician
- Lodi, CA
- NPI 1750878922
-
- Multi-Specialty Clinic/Center
- Ukiah, CA
- NPI 1417295643
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lodi, CA
- NPI 1316938301
-
- Critical Access Hospital
- San Andreas, CA
- NPI 1508968819
-
- General Acute Care Hospital
- Sonora, CA
- NPI 1780673376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1245594167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 S HAM LN STE 26",
"city": "LODI",
"state": "CA",
"postal_code": "952427510",
"telephone_number": "209-368-6661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S HAM LN STE 26",
"city": "LODI",
"state": "CA",
"postal_code": "952427510",
"telephone_number": "209-368-6661",
"fax_number": "209-333-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOURDAJI",
"first_name": "AYAD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-25",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "A153658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.