Individual provider Active NPI

Taline Khoukaz, NP

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1639368103
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP 11729 Issued in CA
Practice address
1441 Eastlake Ave
Nor 8302E
Los Angeles, CA 90089-0112
Phone
(323) 865-3981
Fax
(323) 865-0061
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11729 CA
Acute Care Nurse Practitioner 363LA2100X NP 11729 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave
Nor 8302E
Los Angeles, CA 90089-0112

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3981

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taline.khoukaz@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090623000290 CA Practitioner - Nurse Practitioner 8426109992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP 11729CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jul 20, 2009 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 20, 2009 Accepting new patients
Usc Internal Medicine, Inc. Past Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1441 Eastlake Ave
#8302E
Los Angeles, CA 90089
Phone (323) 865-3000

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

Interoperability endpoints

  • Direct secure messaging: taline.khoukaz@direct.usc.edu

Organizations & group practices 3

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 2

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1639368103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3981",
            "fax_number": "323-865-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "address_2": "NOR 8302E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890112",
            "telephone_number": "323-865-3981",
            "fax_number": "323-865-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOUKAZ",
        "first_name": "TALINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11729",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP 11729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taline.khoukaz@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1441 Eastlake Ave",
            "address_2": "NOR 8302E",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900890112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.