NPIMap

Individual provider Active NPI

Greg S. Khounganian, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Encino, CA
National Provider Identifier
1750560389
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A102948 Issued in CA
Practice address
5363 Balboa Blvd
Ste 245
Encino, CA 91316
Phone
(818) 343-4430
Fax
(818) 343-4423
NPI assigned
Oct 31, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X A102948 CA Primary

Addresses

Primary practice location

5363 Balboa Blvd
Ste 245
Encino, CA 91316

Mailing address

5363 Balboa Blvd
Ste 245
Encino, CA 91316
Phone (818) 343-4430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102948CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jack J Wu MD Inc CurrentSince Nov 17, 2019 Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Reekeshrpatelmd Inc Past Accepting new patients
Denice Starley, DO, a Professional Corporation Past Accepting new patients
Dignity Community Care Past Accepting new patients
Northwest Surgery Center, Inc. Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients

Locations

5363 Balboa Blvd
Ste 245
Encino, CA 91316
Phone (818) 343-4430

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gregkhounganian@1432.securemail.prognocis.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750560389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "STE 245",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-343-4430",
            "fax_number": "818-343-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "STE 245",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-343-4430",
            "fax_number": "818-343-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOUNGANIAN",
        "first_name": "GREG",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A102948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.