GARY KHAMMAHAVONG MD
NPI 1760989636
Emergency Medicine in Van Nuys, CA
About Gary Khammahavong Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GARY KHAMMAHAVONG MD (NPI 1760989636) is an individual emergency medicine provider in Van Nuys, California, licensed in California (A175022) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Warren Alpert Medical School Of Brown University (2018).
NPPES Registry Identity
Specialties & Licenses 2
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
Gary Khammahavong 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.
Medicare Billing Reassignments
6Medicare enrollment records show Gary Khammahavong reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Van Nuys, CA 91405
- Reassigned Medicare billing, California enrollment
- 86 clinicians in this Medicare group
Encino, CA 91436
- Reassigned Medicare billing, California enrollment
- 58 clinicians in this Medicare group
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- 74 clinicians in this Medicare group
Monterey Park, CA 91754
- Reassigned Medicare billing, California enrollment
- 80 clinicians in this Medicare group
Gilroy, CA 95020
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1629301346 (California), NPI 1588721500 (California)
- 2,460 clinicians in this Medicare group
San Jose, CA 95128
- Reassigned Medicare billing, California enrollment
- 197 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
VAN NUYS, CA 91405
VAN NUYS, CA 91405
VAN NUYS, CA 91405
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 Gary Khammahavong's NPI number?
The NPI number for Gary Khammahavong is 1760989636. It was assigned to this individual provider in the NPPES registry on April 9, 2018.
Where is Gary Khammahavong located?
Gary Khammahavong practices at 15107 Vanowen St, Van Nuys, CA 91405. The listed phone number is (818) 782-6600.
What is Gary Khammahavong's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Gary Khammahavong enrolled in Medicare?
Yes. Gary Khammahavong 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 organizations bill Medicare for Gary Khammahavong's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gary Khammahavong reassigns Medicare benefits to 6 organizations: Valley Presbyterian Emergency Medical Associates (Van Nuys, CA), Pacifica Emergency Medical Associates (Encino, CA), Hollywood Presbyterian Emergency Medical Associates, Inc. (Los Angeles, CA), Gem Medical Group Corporation (Monterey Park, CA), County Of Santa Clara (Gilroy, CA) and 1 more organization, listed in the Medicare section above. Each 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 Gary Khammahavong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Gary Khammahavong was last updated on March 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Gary Khammahavong, MD · NPI 1760989636
Emergency Medicine physician in Van Nuys, California. Individual provider, active in the CMS NPPES registry since April 9, 2018.
## Identity
- **NPI:** 1760989636 (Entity type: Individual)
- **Enumerated:** April 9, 2018
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** A175022 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 15107 VANOWEN ST, Van Nuys, CA 91405-4542
- **Phone:** (818) 782-6600
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Valley Presbyterian Emergency Medical Associates (NPI 1033133103, Van Nuys, CA); Pacifica Emergency Medical Associates (NPI 1053350975, Encino, CA); Hollywood Presbyterian Emergency Medical Associates, Inc. (NPI 1972826931, Los Angeles, CA); Gem Medical Group Corporation (NPI 1689386815, Monterey Park, CA); County Of Santa Clara (NPI 1922093533, Gilroy, CA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Warren Alpert Medical School Of Brown University, class of 2018
## Record status
- **NPPES last updated:** March 2, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1760989636) · Data from the CMS NPPES public registry.