Individual provider Active NPI

John Oliver Elkhoury, PA

  • Physician Assistant
  • West Grove, PA
National Provider Identifier
1669937496
Registry record updated Nov 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060508 Issued in PA
Practice address
1015 W Baltimore Pike
West Grove, PA 19390-9459
Phone
(610) 869-1000
NPI assigned
Feb 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA060508 PA
Physician Assistant 363A00000X MA060508 PA Primary

Addresses

Primary practice location

1015 W Baltimore Pike
West Grove, PA 19390-9459

Mailing address

1015 W Baltimore Pike
West Grove, PA 19390-9459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190513000230 PA Practitioner - Physician Assistant 2567705643 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA060508PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Grove Clinic Company LLC CurrentSince Nov 1, 2019 Accepting new patients
HR Physician Services CurrentSince Nov 11, 2023 Accepting new patients
HR Physician Services Emergency Medicine CurrentSince Nov 11, 2023 Accepting new patients

Locations

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1015 W Baltimore Pike
West Grove, PA 19390
Phone (610) 869-1000

1011 W Baltimore Pike
Ste 307
West Grove, PA 19390
Phone (610) 869-1240

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1669937496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W BALTIMORE PIKE",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W BALTIMORE PIKE",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909459",
            "telephone_number": "610-869-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKHOURY",
        "first_name": "JOHN",
        "middle_name": "OLIVER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-06",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MA060508",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Grove, PA

Sources for this page

Verify at the official NPI Registry.