NPIMap

Individual provider Active NPI

Michael Osama Khoury, DO

  • Emergency Medicine Physician
  • Ephrata, PA
National Provider Identifier
1407478001
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS022749 Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1734
Phone
(717) 738-6618
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS022749 PA Primary

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1734

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230710002848 PA Practitioner - Emergency MedicinePractitioner - Medical Toxicology 3678996683 Reassigns benefits to 2 organizations
I20251001003210 VA Practitioner - Emergency Medicine 3678996683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fredericksburg Emergency Medical Alliance, Inc.Group PAC ID 2163412636, 47 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS022749PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital CurrentSince Jul 16, 2023 Accepting new patients
Ephrata Community Hospital Emergency Medicine CurrentSince Jul 16, 2023 Accepting new patients
Ephrata Community Hospital Emergency Medicine Current Accepting new patients
Fredericksburg Emergency Medical Alliance, Inc. Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2023 Accepting new patients
Einstein Practice Plan, Inc CurrentSince Jul 1, 2023 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

169 Martin Ave
#1002
Ephrata, PA 17522
Phone (717) 738-6818

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Interoperability endpoints

  • Direct secure messaging: mkhoury186990@wellspan.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1407478001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221734",
            "telephone_number": "717-738-6618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "MICHAEL",
        "middle_name": "OSAMA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS022749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.