Individual provider Active NPI

Rami Wasfi Al Khoury, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1487207585
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39205 Issued in OK
Practice address
1541 Kings Highway
Internal Medicine
Shreveport, LA 71130-3932
Phone
(318) 626-0436
NPI assigned
Jul 18, 2019
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39205 OK Primary

Addresses

Primary practice location

1541 Kings Highway
Internal Medicine
Shreveport, LA 71130-3932

Mailing address

1541 Kings Highway
Internal Medicine
Shreveport, LA 71130-3932
Phone (318) 626-0436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220729002378 OK Practitioner - Internal Medicine 8224369616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Hospital Medicine Physicians Group, LLCGroup PAC ID 7214327832, 132 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Hillcrest Medical Center
Tulsa, OK 74104-4012
Phone (918) 579-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.31 of 100Reported as group
Improvement activities
20
Cost
82.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39205OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Hospital Medicine Physicians Group, LLC Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

Interoperability endpoints

  • Direct secure messaging: ralkhoury576545@ahs.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1487207585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HIGHWAY",
            "address_2": "INTERNAL MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711303932",
            "telephone_number": "318-626-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HIGHWAY",
            "address_2": "INTERNAL MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711303932",
            "telephone_number": "318-626-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL KHOURY",
        "first_name": "RAMI",
        "middle_name": "WASFI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-18",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "39205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.