Nidal Khaja, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4807 Issued in CA

Practice address

1246 W 155TH St
Gardena, CA 90247-4011

Phone

(310) 768-2256

Fax

(310) 323-0914

NPI assigned

Jun 17, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• All South Bay Footcare Podiatry Group, Inc.

  • Foot Surgery Podiatrist
  • Torrance, CA
  • NPI 1457499725

  Foot & Ankle Surgery

  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD
• Choice Physical Therapy & Rehab PC

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1457875494
  NPD (past)
• Helen Kuo DPM Inc

  • Foot & Ankle Surgery Podiatrist
  • Torrance, CA
  • NPI 1093824633
  NPD (past)
• Progressive Medical Group Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1760767347
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1013177633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 DEEP VALLEY DR",
            "address_2": "# 4055",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902743876",
            "telephone_number": "310-538-1110",
            "fax_number": "310-538-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 W 155TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474011",
            "telephone_number": "310-768-2256",
            "fax_number": "310-323-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAJA",
        "first_name": "NIDAL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL1636",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasmine Kennedy
• Candice Kent, APSW
• Kenzo Otsuji Optometric Corp
• Cynthia Key, PMHNP
• Christa Timil Jafre Keyes-Venson
• Anna Marie Khaldi
• Mena Khalil
• Manoutcher Khalili, MD
• Khadeer Khan, MSN, DNP, FNP, PMHNP
• Melba K Khan, NONE

• Foot & Ankle Surgery Podiatrist in Gardena, CA
• Providers in Gardena, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.