GRACE NIMAT KHOURI (MD) – General Practice Physician, NPI 1063489151
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for GRACE NIMAT KHOURI (MD)
PO BOX 8674 1230 E. MAIN STREET
MANKATO CLINIC LTD
MANKATO, MN 560028674
Phone: (507) 625-1811
Fax: (952) 483-4301
Type: Mailing
Mankato Clinic, 1230, East Main Street, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO CLINIC, LTD
MANKATO, MN 560028674
Phone: (507) 625-1811
Fax: (952) 843-4301
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-04-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20070104000347 | I | General Practice | MN | TBD |
| I20250407001671 | I | General Practice | WI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56002)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MN | |
| Nurse Practitioner | MN | |
| Diagnostic Radiology | CO | |
| Physician Assistant | MN | |
| P O D I A T R Y | MN | |
| - | MN | |
| - | MN | |
| General Surgery | MN | |
| Diagnostic Radiology, Internal Medicine | MN | |
| N E U R O L O G Y | MN |
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