NPIMap

Individual provider Active NPI

Ali A. Khaki, M.D.

  • Surgery Physician
  • Lincoln City, OR
National Provider Identifier
1477591923
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD23308 Issued in OR
Practice address
3100 NE 28TH St Ste E
Lincoln City, OR 97367-4524
Phone
(541) 994-8114
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD23308 OR Primary

Addresses

Primary practice location

3100 NE 28TH St Ste E
Lincoln City, OR 97367-4524

Mailing address

PO Box 1194
Corvallis, OR 97339-1194

Other practice location 1

9155 SW Barnes Rd
Suite 830
Portland, OR 97225-6625
Phone (503) 229-7431

Other identifiers 1

IdentifierTypeStateIssuer
074703MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akhaki130482@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040518001109 OR Practitioner - General Surgery 8527059716 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan North Lincoln HospitalGroup PAC ID 7911816301, 42 clinicians

Practice addresses (Care Compare)

3100 NE 28TH St
Suite C
Lincoln City, OR 97367-4524
Phone (541) 994-8114

Hospital & facility affiliations

  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23308ORMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan North Lincoln Hospital CurrentSince Dec 1, 2025 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jun 30, 2016 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Jul 1, 2018 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Jul 1, 2018 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Edward S Phinney Jr, MD, PC Surgery PastSince Jul 1, 2002 Accepting new patients
Samaritan North Lincoln Hospital Surgery PastSince Nov 8, 2020 Accepting new patients

Locations

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

3100 NE 28th St
Ste C
Lincoln City, OR 97367
Phone (541) 557-6417

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Organizations & group practices 10

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 8

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1477591923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NE 28TH ST STE E",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674524",
            "telephone_number": "541-994-8114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9155 SW Barnes Rd",
            "address_2": "SUITE 830",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256625",
            "country_code": "US",
            "telephone_number": "503-229-7431",
            "fax_number": "503-292-1433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAKI",
        "first_name": "ALI",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD23308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074703",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhaki130482@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3100 NE 28th St Ste E",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973674524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.