Amanda Khoury

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

12612990-0501 Issued in UT

Practice address

24 S 1100 E Ste 210
Salt Lake City, UT 84102-1580

Phone

(801) 505-5277

Fax

(801) 505-5280

NPI assigned

May 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Foot Care IncGroup PAC ID 0345329686, 127 clinicians

Dr Bob S Salk DPM PC ApcGroup PAC ID 3274703749, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047

Merit-based Incentive Payment System (MIPS)

Final score

93.57 of 100Reported as individual

Quality

73.9

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akhoury676223@hisp.ehr.sutterhealth.org
• Direct secure messaging: amanda.khoury.1@20181.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 and National Provider Directory roles.

• Bay Area Foot Care, Inc

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
  • NPI 1508911892
  Medicare reassignment Care Compare group NPD
• Dr Bob S Salk DPM PC Apc

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
  • NPI 1730366261
  Medicare reassignment Care Compare group NPD
• Bay Area Foot Care Inc

  • Foot & Ankle Surgery Podiatrist
  • San Jose, CA
  • NPI 1649136490
  NPD
• Dr Bob S Salk DPM PC Apc

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
  • NPI 1376005678
  NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)

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

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1740348929
  Care Compare affiliation

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1417512898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106236",
            "telephone_number": "801-505-0821",
            "fax_number": "801-505-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021580",
            "telephone_number": "801-505-5277",
            "fax_number": "801-505-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954927",
            "country_code": "US",
            "telephone_number": "631-376-3000",
            "fax_number": "631-376-3420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8822 S Redwood Rd Ste E1",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840889336",
            "country_code": "US",
            "telephone_number": "801-285-7060",
            "fax_number": "801-285-7061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "12612990-0501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12612990-0501",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kholbas Inc, Dba Soriba.Org Transportation
• Tiffany Khong
• Lillian Lei Ching Khor, M.D.
• Andrei Khorovets, MD
• Ashley Khouri, MD
• George Khoury
• Reham Simon Khoury
• Ahmad Khraisat
• Rabia N. Kiani, MBBS
• Chelsea Kidd, MD

• Foot & Ankle Surgery Podiatrist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Foot & Ankle Surgery Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.