NPIMap

Individual provider Active NPI

Antoine B Khoury, MD

  • Cardiovascular Disease Physician
  • Saint Paul, MN
National Provider Identifier
1659345064
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
41952 Issued in MN
Practice address
640 Jackson St
MC 11102H
Saint Paul, MN 55101
Phone
(651) 254-5175
Fax
(651) 254-1603
NPI assigned
Feb 14, 2006
Last updated
May 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 41952 MN Primary

Addresses

Primary practice location

640 Jackson St
MC 11102H
Saint Paul, MN 55101

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
511090400MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100322000966 MN Practitioner - Cardiovascular Disease (Cardiology) 2062547599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of North Carolina at Chapel Hill School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

14701 Victor Hugo Blvd N
Hugo, MN 55038-4561
Phone (651) 767-1900

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900

205 Wabasha Ave S
Saint Paul, MN 55107-1805

233 Radio Dr
Woodbury, MN 55125-5805
Phone (952) 967-7616

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

2831 Snelling N Ave
Roseville, MN 55113-2460
Phone (651) 636-4525

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

4730 Chicago Ave S
Minneapolis, MN 55407-3570
Phone (952) 967-7485

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Aug 16, 1999 Accepting new patients
Group Health, Inc. CurrentSince Aug 16, 1999 Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

640 Jackson St
#11102H
Saint Paul, MN 55101
Phone (651) 254-3462

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
Stillwater, MN 55082

Interoperability endpoints

  • Direct secure messaging: akhoury25080@direct.healthpartners.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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1659345064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "address_2": "MC 11102H",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-5175",
            "fax_number": "651-254-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "ANTOINE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "41952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511090400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.