Individual provider Active NPI

Mona Khoury

  • Primary Podiatric Medicine Podiatrist
  • Brooklyn, NY
National Provider Identifier
1417030412
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
N004635-1 Issued in NY
Practice address
1407 Avenue U
Brooklyn, NY 11229
Phone
(718) 998-6684
Fax
(718) 998-0513
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X N004635-1 NY Primary

Addresses

Primary practice location

1407 Avenue U
Brooklyn, NY 11229

Mailing address

1685 B Grand Avenue
Baldwin, NY 11510
Phone (516) 378-1280

Other identifiers 1

IdentifierTypeStateIssuer
02088342MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000383 NY Practitioner - Podiatry 8325243504 Practice locations: Baldwin, NY; Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1407 Ave U
Brooklyn, NY 11229-3319
Phone (718) 998-6684

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1188
Removal or shaving of skin growth744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004635-1NYMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Downstate Foot and Ankle Podiatry, PC Primary Podiatric Medicine PastSince Jun 1, 1992 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1417030412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 B GRAND AVENUE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "11510",
            "telephone_number": "516-378-1280",
            "fax_number": "516-378-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-998-6684",
            "fax_number": "718-998-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "MONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N004635-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02088342",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.