Individual provider Active NPI

Lyanne Marie Santana Khoury, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Brookline, MA
National Provider Identifier
1972276608
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD21078 Issued in RI
Practice address
1 Brookline PL Ste 230
Brookline, MA 02445-7224
Phone
(401) 456-2000
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 3015628 MA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD21078 RI Primary
Internal Medicine Physician 207R00000X MD21078 RI

Addresses

Primary practice location

1 Brookline PL Ste 230
Brookline, MA 02445-7224

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 273-0641

Other practice location 1

215 Toll Gate Rd Ste 104
Warwick, RI 02886-4463
Phone (401) 921-7290

Other practice location 2

1405 S County Trl Ste 1A
East Greenwich, RI 02818-5081
Phone (401) 921-7290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604000686 RI Practitioner - Geriatric Medicine 7810360245

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2770

455 Toll Gate Road Warwick Ri
02886 PRC and Credentialing
Warwick, RI 02886

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3015628MAMDGeriatric Medicine (Internal Medicine) Physician
MD21078RIMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1972276608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL STE 230",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457224",
            "telephone_number": "401-456-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Toll Gate Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864463",
            "country_code": "US",
            "telephone_number": "401-921-7290",
            "fax_number": "401-921-6194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 S County Trl Ste 1A",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028185081",
            "country_code": "US",
            "telephone_number": "401-921-7290",
            "fax_number": "401-921-6194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTANA KHOURY",
        "first_name": "LYANNE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "3015628",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "MD21078",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD21078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.