Individual provider Active NPI

Puneet K Khanna, M.D.

  • Interventional Cardiology Physician
  • Rancho Mirage, CA
National Provider Identifier
1053372466
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
45577 Issued in CA
Practice address
39000 Bob Hope Dr
Hal B Wallis
Rancho Mirage, CA 92270-3221
Phone
(760) 346-0642
NPI assigned
Mar 28, 2006
Last updated
Jan 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A45577 CA
Interventional Cardiology Physician 207RI0011X 45577 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Hal B Wallis
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Hal B Wallis
Rancho Mirage, CA 92270-3221
Phone (760) 346-0642

Other identifiers 1

IdentifierTypeStateIssuer
00A455770MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080512000763 CA Practitioner - Cardiovascular Disease (Cardiology) 8921995291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 773-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting96
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45577CAMDPharmacist
A45577CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Nov 15, 2020 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Diagnostic Imaging Services Past Accepting new patients

Locations

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
#B
Rancho Mirage, CA 92270
Phone (760) 346-0642

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39700 Bob Hope Dr
Ste 203
Rancho Mirage, CA 92270
Phone (760) 341-0889

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

Interoperability endpoints

  • Direct secure messaging: pkhanna15529@edirect.emc.org

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1053372466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "HAL B WALLIS",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "HAL B WALLIS",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "PUNEET",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A45577",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "45577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A455770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.