Individual provider Active NPI

Johnny Michel Khoury, M.D.

  • Ophthalmology Physician
  • Las Vegas, NV
National Provider Identifier
1255475299
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
12179 Issued in NV
Practice address
7521 W Lake Mead Blvd
Las Vegas, NV 89128-0274
Phone
(702) 804-5556
Fax
(702) 804-1635
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 12179 NV Primary

Addresses

Primary practice location

7521 W Lake Mead Blvd
Las Vegas, NV 89128-0274

Mailing address

3155D Sedona CT
Ste 100
Ontario, CA 91764-6555
Phone (909) 698-9780

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
I20210311001686 CA Practitioner - Ophthalmology 3577627736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
81.78
Promoting interoperability
74
Improvement activities
40
Cost
78.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12179NVMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas S Tooma M D a Professional Corporation Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Thomas S Tooma M D a Professional Corporation Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Eye Care Associates of Nevada Las Vegas, Inc Ophthalmology Past Accepting new patients
Thomas S. Tooma, M.D. a Professional Corporation Ophthalmology Past Accepting new patients

Locations

75 Enterprise
Ste 200
Aliso Viejo, CA 92656
Phone (949) 688-6205

1400 N Harbor Blvd
Ste 130
Fullerton, CA 92835
Phone (714) 750-8443

4220 Von Karman Ave
Ste 100
Newport Beach, CA 92660
Phone (949) 284-7428

3155 Sedona Ct
Ste 100
Ontario, CA 91764
Phone (909) 605-1975

3655 Nobel Dr
Ste 130
San Diego, CA 92122
Phone (858) 283-5371

Organizations & group practices 4

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1255475299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155D SEDONA CT",
            "address_2": "STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646555",
            "telephone_number": "909-698-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7521 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280274",
            "telephone_number": "702-804-5556",
            "fax_number": "702-804-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "JOHNNY",
        "middle_name": "MICHEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "12179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.