JON KHOURY (PA) – Emergency Medical Services (Emergency Medicine) Physician, NPI 1154424463
Emergency Medical Services (Emergency Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for JON KHOURY (PA)
PO BOX 3157
INDIANAPOLIS, IN 462063157
Phone: (770) 405-2976
Type: Mailing
55 Whitcher St NE
Suite 160
Marietta, GA 300601155
Phone: (770) 422-1372
Fax: (770) 423-9651
Type: Location
55, Whitcher Street Northwest, Elizabeth, Marietta, Cobb, Georgia, 30060, United States
SUITE 160
MARIETTA, GA 300601155
Phone: (770) 422-1372
Fax: (770) 423-9651
Type: Mailing
790 CHURCH ST NE STE 400
MARIETTA, GA 300608957
Phone: (770) 405-2976
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $337.
Total Amount is formed as General ($337) + Research ($0) + Ownership ($0) = $337.
Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Bard Peripheral Vascular, Inc. ($161).
Total Amount
$337
General + Research + Ownership
Payments
4
Total payment records
General Amount
$337
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bard Peripheral Vascular, Inc. | $161 |
| Penumbra, Inc. | $133 |
| ABIOMED | $43 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-02-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050214000960 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 49083 | Drainage of fluid from abdominal cavity using imaging guidance | 23 | 15 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 19 | 19 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 46206)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | NY | |
| Diagnostic Radiology | VA | |
| - | GA | |
| - | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| - | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | GA | |
| Diagnostic Radiology, Interventional Radiology | IN |
Reviews
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