Individual provider Active NPI

Nicolas E Makhoul, M.D.

  • Family Medicine Physician
  • Pleasant Hill, CA
National Provider Identifier
1639109515
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A61634 Issued in CA
Practice address
401 Gregory LN
Suite 104
Pleasant Hill, CA 94523-2800
Phone
(925) 682-2401
Fax
(925) 674-4721
NPI assigned
Jul 4, 2006
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A61634 CA Primary

Addresses

Primary practice location

401 Gregory LN
Suite 104
Pleasant Hill, CA 94523-2800

Mailing address

Dept 34929
P,O. 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828

Other identifiers 1

IdentifierTypeStateIssuer
00A616340MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070705000656 CA Practitioner - Family Practice 7719087683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

1505 Saint Alphonsus Way
Alamo, CA 94507-1570
Phone (925) 932-6330

401 Gregory LN
Suite 104
Pleasant Hill, CA 94523-2851
Phone (925) 430-5833

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61634CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Bass Medical Group Family Medicine Current Accepting new patients
Bass Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Bass Medical Group Past Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

401 Gregory Ln
Ste 104
Pleasant Hill, CA 94523
Phone (925) 430-5833

Interoperability endpoints

  • Direct secure messaging: nmakhoul8243@ehr.johnmuirhealth.com

Organizations & group practices 7

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 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1639109515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P,O. 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GREGORY LN",
            "address_2": "SUITE 104",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232800",
            "telephone_number": "925-682-2401",
            "fax_number": "925-674-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHOUL",
        "first_name": "NICOLAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A61634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A616340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.