WISSAM E KHOURY (DPM) – Podiatrist, NPI 1104886910
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
953 PODIATRY in OH
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Provider Addresses for WISSAM E KHOURY (DPM)
Lubben & Associates Addiction Counseling, 429, Front Street, Berea, Cuyahoga County, Ohio, 44017, United States
BEREA, OH 440171716
Phone: (216) 367-9444
Type: Mailing
St. Vincent Charity Medical Center, 2351, East 22nd Street, Playhouse Square, Cleveland, Cuyahoga County, Ohio, 44115, United States
CLEVELAND, OH 44115
Phone: (216) 367-9444
Fax: (216) 453-0331
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $154.
Total Amount is formed as General ($154) + Research ($0) + Ownership ($0) = $154.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Abbott Laboratories ($140).
Total Amount
$154
General + Research + Ownership
Payments
2
Total payment records
General Amount
$154
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $140 |
| CashFlow Solutions, LLC | $14 |
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: 2004-08-26
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 |
|---|---|---|---|---|
| I20040826000051 | I | Podiatry | OH | 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 |
|---|---|---|---|---|
| 11721 | Removal of fingernails or toenails, 6 or more nails | 46 | 17 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 27 | 15 | $0 |
Insurance plans in this area (ZIP 44017)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PODIATRY | OH | 11042 | Removal of skin and tissue first 20 sq cm or less | 22 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Clinical Nurse Specialist (Cns) | OH | |
| Nurse Practitioner | OH |
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