NPIMap

Individual provider Active NPI

Sami Khoshyomn, M.D.

  • Neurological Surgery Physician
  • Springfield, MO
National Provider Identifier
1699719963
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2005000362 Issued in MO
Practice address
1965 S Fremont Ave
Suite 130
Springfield, MO 65804-2201
Phone
(417) 820-5150
Fax
(417) 820-5155
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2005000362 MO Primary

Addresses

Primary practice location

1965 S Fremont Ave
Suite 130
Springfield, MO 65804-2201

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 1

IdentifierTypeStateIssuer
207309600MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050805000097 MO Practitioner - Neurosurgery 6709815244 Reassigns benefits to 3 organizations
I20200328000031 AR Practitioner - Neurosurgery 6709815244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
  • Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 14, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 1, 2005 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 6, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Apr 14, 2020 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Oct 31, 2014 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 1, 2005 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 14, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Apr 14, 2020 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

2708 S Rife Medical Ln
Ste 140
Rogers, AR 72758
Phone (479) 338-3720

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Ste 410
Joplin, MO 64804
Phone (417) 556-6875

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1965 S Fremont Ave
Ste 130
Springfield, MO 65804
Phone (417) 820-5150

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: skhoshyomn767@directb.mercy.net
  • Direct secure messaging: skhoshyomn18289@directc.mercy.net

Organizations & group practices 10

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 12

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1699719963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE",
            "address_2": "SUITE 130",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042201",
            "telephone_number": "417-820-5150",
            "fax_number": "417-820-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHYOMN",
        "first_name": "SAMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2005000362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207309600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.