Wisam Joseph Khoury, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G79795 Issued in CA

Practice address

1818 Verdugo Blvd
Suite 302
Glendale, CA 91208-1403

Phone

(818) 427-4116

NPI assigned

Jun 8, 2006

Last updated

Dec 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 PracticeAlso: Critical Care (Intensivists), Emergency Medicine

Education

Loma Linda University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medamerica Physician Solutions PCGroup PAC ID 8729221809, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: sam.khoury.1@20515.direct.athenahealth.com

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.

• Medamerica Physician Solutions PC

  dba Jovive Wound Care

  • Clinic/Center
  • Walnut Creek, CA
  • NPI 1487237111
  Medicare reassignment Care Compare group NPD
• Beaver Medical Group P C

  dba Beaver Advantage Health Center

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1275570830
  NPD (past)
• Llorens Pembrook, MD Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Van Nuys, CA
  • NPI 1750577359
  NPD (past)
• Valley Emergency Medical Associates

  • Emergency Medicine Physician
  • Panorama City, CA
  • NPI 1801837299
  NPD (past)

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

• Usc Verdugo Hills Hospital

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1033716147
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1356381966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-427-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 302",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-427-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "WISAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G797950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MILITARY SERVICE",
            "identifier": "7452",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sajad Khosh, DDS
• Rodrik Khosrovian, D.C.
• Lory Khoudikian, LMFT
• Bill J. Khoury, M.D.
• Jeanine Chafik Farid Khoury, DDS
• Gagik Khoylyan, M.D.
• Ani Halabi Khroyan, O.D.
• KHT Care Plus Group Inc
• Petros Khtryan
• Marina Khubesrian, M.D.

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, 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 Dec 28, 2012; 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.