NPIMap

Individual provider Active NPI

Issa Samir Khoury, M.D.

  • Diagnostic Radiology Physician
  • Yonkers, NY
National Provider Identifier
1487008355
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
30802601 Issued in NY
Practice address
967 N Broadway
Yonkers, NY 10701-1301
Phone
(914) 964-4444
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 30802601 NY Primary

Addresses

Primary practice location

967 N Broadway
Yonkers, NY 10701-1301

Mailing address

967 N Broadway
Yonkers, NY 10701-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221004002882 NY Practitioner - Diagnostic Radiology 3577949205 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians
White Plains Physician Services PCGroup PAC ID 3476894445, 386 clinicians
Winifred Masterson Burke Rehabilitation HospitalGroup PAC ID 4385551241, 12 clinicians

Practice addresses (Care Compare)

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-0600

600 Mamaroneck Ave
Harrison, NY 10528-1635
Phone (914) 723-8100

785 Mamaroneck Ave
White Plains, NY 10605-2523
Phone (914) 597-2500

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304
  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264
  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30802601NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winifred Masterson Burke Rehabilitation Hospital CurrentSince Oct 1, 2022 Accepting new patients
East Post Road Medical Services PC Diagnostic Radiology CurrentSince Jun 22, 2022 Accepting new patients
Winifred Masterson Burke Rehabilitation Hospital CurrentSince Oct 1, 2022 Accepting new patients

Locations

750 White Plains Rd
Scarsdale, NY 10583
Phone (914) 597-3880

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

785 Mamaroneck Ave
White Plains, NY 10605
Phone (914) 597-2257

Networks

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

Organizations & group practices 4

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 7

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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1487008355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011301",
            "telephone_number": "914-964-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "ISSA",
        "middle_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "30802601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.