Active NPI
Lyanne Marie Santana Khoury, MD
- Geriatric Medicine (Internal Medicine) Physician
- Brookline, MA
National Provider Identifier
1972276608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MD21078
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3015628 | MA | MD | Geriatric Medicine (Internal Medicine) Physician |
| MD21078 | RI | MD | Geriatric 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.