NPIMap

Individual provider Active NPI

Raymond Khoudary, MD

  • Allergy & Immunology Physician
  • Plains, PA
National Provider Identifier
1396727236
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD048279L Issued in PA
Practice address
190 S River St
Plains, PA 18705-1149
Phone
(570) 970-1400
Fax
(570) 970-1403
NPI assigned
Nov 16, 2005
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD048279L PA Primary

Addresses

Primary practice location

190 S River St
Plains, PA 18705-1149

Mailing address

190 S River St
Plains, PA 18705-1149
Phone (570) 970-1400

Other identifiers 1

IdentifierTypeStateIssuer
0014930060002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229000800 PA Practitioner - Allergy/Immunology 9234327610 Receives reassigned benefits from 1 practitioner
Practice locations: Plains, PA

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

190 S River St
Plains, PA 18705-1149
Phone (570) 970-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.05 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD048279LPAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond Khoudary MDPC PastSince Sep 1, 1997 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 1

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1396727236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051149",
            "telephone_number": "570-970-1400",
            "fax_number": "570-970-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051149",
            "telephone_number": "570-970-1400",
            "fax_number": "570-970-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOUDARY",
        "first_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD048279L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014930060002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plains, PA

Sources for this page

Verify at the official NPI Registry.