Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALISA KHOMUTOVA MD
NPI 1659908960
Surgery in Knoxville, TN

Q: What is Alisa Khomutova's NPI number?

The NPI number for Alisa Khomutova is 1659908960. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Q: What is Alisa Khomutova's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Alisa Khomutova was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 25, 2020PECOS EnrolledAccepts Medicare Assignment

1924 ALCOA HWY, KNOXVILLE, TN 37920(818) 523-6550 Get Directions Write a Review

NPPES record last updated: September 18, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 18, 2026, Aug 8, 2025, Mar 25, 2020 (3 updates tracked since 2020).

On this page

About Alisa Khomutova Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALISA KHOMUTOVA MD (NPI 1659908960) is an individual surgery provider in Knoxville, Tennessee, licensed in Tennessee (73554) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and maintains a secondary practice location in Rancho Mirage.

NPPES Registry Identity

NPI1659908960

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameALISA KHOMUTOVACredential: MD

Location Address1924 ALCOA HWYKnoxville, TN 37920-1511

Mailing Address7924 Woodman Ave Unit 12Panorama City, CA 91402-6225 · (818) 212-9962

Phone(818) 523-6550

Sole ProprietorYes

Medical School CMSOakland Univ, William Beaumont School Of MedicineGraduated 2020

Enumeration DateMarch 25, 2020

Last NPPES UpdateSeptember 18, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 18, 2026

✔ NPI 1659908960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in TN · 73554✔ Licensed in CA · A211626

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

1924 ALCOA HWY, Knoxville, TN 37920

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Secondary Practice Location 1

Location 139000 Bob Hope DrRancho Mirage, CA 92270-3202 · Phone (760) 837-8601 · Fax (760) 837-8611

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alisa Khomutova Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921500299

PECOS Enrollment IDI20250905002501

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Alisa Khomutova reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Health System, Inc

Same address

Dermatology

1924 ALCOA HWY
Knoxville, TN 37920

Reassigned Medicare billing, Tennessee enrollment
832 clinicians in this Medicare group

NPI 1083332951 (865) 305-9410

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Health System, Inc

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440015

Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37920 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SUSANNE LORI MITCHELL RN

Registered Nurse (Obstetric, High-Risk)

1924 ALCOA HWY, 6S
KNOXVILLE, TN 37920

Knox County (865) 305-8888

DR. FELIX JOSEPH NEPVEUX V M.D.

Student in an Organized Health Care Education/Training Program

1924 ALCOA HWY, UNIV. OF TENNESSEE MEDICAL CENTER, DEPT. OF PATHOLOGY
KNOXVILLE, TN 37920

Knox County (864) 498-8960

DR. SPENCER PUGH M.D.

Internal Medicine (Pulmonary Disease)

1924 ALCOA HWY, DEPARTMENT OF MEDICINE U-114 GSM, UTMCK
KNOXVILLE, TN 37920

Knox County (865) 305-9340

CAITLIN TABLER LOWE

Nurse Practitioner (Gerontology)

1924 ALCOA HWY
KNOXVILLE, TN 37920

Knox County (865) 305-7255

CHRISTIAN BAYLESS CRNA

Nurse Anesthetist, Certified Registered

1924 ALCOA HWY
KNOXVILLE, TN 37920

Knox County (865) 305-9000

JOAN JAKAB

Pharmacist

1924 ALCOA HWY
KNOXVILLE, TN 37920

Knox County (865) 305-5337

UNIVERSITY PATHOLOGISTS, P.C.

Pathology (Anatomic Pathology & Clinical Pathology)

1924 ALCOA HWY
KNOXVILLE, TN 37920

Knox County (865) 305-9080

DAPHNE M. NORWOOD, MD

Internal Medicine

1924 ALCOA HWY, BOX U114
KNOXVILLE, TN 37920

Knox County (865) 305-9349

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alisa Khomutova's NPI number?

The NPI number for Alisa Khomutova is 1659908960. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Where is Alisa Khomutova located?

Alisa Khomutova practices at 1924 Alcoa Hwy, Knoxville, TN 37920. The listed phone number is (818) 523-6550.

What is Alisa Khomutova's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Alisa Khomutova enrolled in Medicare?

Yes. Alisa Khomutova is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Alisa Khomutova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alisa Khomutova reassigns Medicare benefits to University Health System, Inc (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alisa Khomutova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Alisa Khomutova accept?

Health plans from BlueCross BlueShield of Tennessee and Cigna Healthcare list Alisa Khomutova as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Alisa Khomutova affiliated with any hospitals?

According to CMS data, Alisa Khomutova is affiliated with University Health System, Inc.

When was this NPI record last updated?

The NPPES record for Alisa Khomutova was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.