NPIMap

Individual provider Active NPI

Herkanwal S. Khaira, MD

  • Urology Physician
  • Fairfield, CA
National Provider Identifier
1073691564
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A95113 Issued in CA
Practice address
1860 Pennsylvania Ave Ste 200
200
Fairfield, CA 94533-3550
Phone
(707) 646-4180
Fax
(707) 646-4181
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A95113 CA Primary

Addresses

Primary practice location

1860 Pennsylvania Ave Ste 200
200
Fairfield, CA 94533-3550

Mailing address

1860 Pennsylvania Ave Ste 200
200
Fairfield, CA 94533-3550
Phone (707) 646-4180

Other identifiers 1

IdentifierTypeStateIssuer
1073691564MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070306000310 CA Practitioner - Urology 6406959873 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Southern California Keck School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1860 Pennsylvania Ave
Fairfield, CA 94533-3590
Phone (707) 646-4114

1860 Pennsylvania Ave
Suite 200
Fairfield, CA 94533-3550
Phone (707) 646-4180

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95113CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group Current Accepting new patients
Northbay Healthcare Group CurrentSince Jun 15, 2015 Accepting new patients
State of California - Department of Developmental Services Current Accepting new patients
Agnews Community Clinic CurrentSince Jul 3, 2015 Accepting new patients
State of California - Department of Developmental Services CurrentSince Jul 3, 2015 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533
Phone (707) 427-5211

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

3250 Beard Rd
Napa, CA 94558
Phone (707) 224-7944

26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222

421 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 455-3000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1073691564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE STE 200",
            "address_2": "200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333550",
            "telephone_number": "707-646-4180",
            "fax_number": "707-646-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE STE 200",
            "address_2": "200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333550",
            "telephone_number": "707-646-4180",
            "fax_number": "707-646-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRA",
        "first_name": "HERKANWAL",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A95113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073691564",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.