Sam Khoo, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13943 Issued in CA

Practice address

476 E. Washington Street
Earlimart, CA 93219

Phone

(661) 849-2638

Fax

(661) 849-5719

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sam.khoo.1@17661.direct.athenahealth.com

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.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)
• United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Huron, CA
  • NPI 1134101686
  NPD (past)
• United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1437902566
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891815080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "address_2": "650 ZEDIKER AVE.",
            "city": "PARLIER",
            "state": "CA",
            "postal_code": "936480790",
            "telephone_number": "559-646-6618",
            "fax_number": "559-646-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 E. WASHINGTON STREET",
            "city": "EARLIMART",
            "state": "CA",
            "postal_code": "93219",
            "telephone_number": "661-849-2638",
            "fax_number": "661-849-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOO",
        "first_name": "SAM",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA PA LIC#",
            "identifier": "PA13943",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Victoria Garibay
• Jennifer Esmeralda Gonzalez
• Vanessa Hernandez
• Imgrx SJ Valley, Inc.
• Baljeet Kaur
• Joseph Vincent Maddela, MD
• Cynthia Anjanette Madera
• Blanca Mejia, PSY.D.
• Yasmin Ortiz
• Puneet Kaur Pandher, DDS

• All providers in Earlimart, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.