Individual provider Active NPI

Ludwig E Khoury, MD

  • Allergy & Immunology Physician
  • Watertown, NY
National Provider Identifier
1356354633
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
241599 Issued in NY
Practice address
532 Coffeen St
Watertown, NY 13601-2421
Phone
(315) 788-1100
Fax
(315) 788-1188
NPI assigned
Aug 15, 2006
Last updated
Oct 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 241599 NY Primary
Allergy & Immunology Physician 207K00000X K5132 TX

Addresses

Primary practice location

532 Coffeen St
Watertown, NY 13601-2421

Mailing address

PO Box 8086
Utica, NY 13505
Phone (315) 624-7911

Other identifiers 1

IdentifierTypeStateIssuer
02893667MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070716000255 NY Practitioner - Allergy/Immunology 9537191101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergycare PLLCGroup PAC ID 1456451798, 2 clinicians

Practice addresses (Care Compare)

532 Coffeen St
Watertown, NY 13601-2421

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Care PLLC Allergy & Immunology PastSince Jan 1, 1990 Accepting new patients
Ludwig E. Khoury M.D. P.a. Allergy & Immunology Past Accepting new patients
Allergy Care, PLLC Allergy & Immunology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1356354633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8086",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13505",
            "telephone_number": "315-624-7911",
            "fax_number": "315-624-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 COFFEEN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012421",
            "telephone_number": "315-788-1100",
            "fax_number": "315-788-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "LUDWIG",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "241599",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "K5132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02893667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.