Individual provider Active NPI

Shehma Khan, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Madera, CA
National Provider Identifier
1083732648
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
A99004 Issued in CA
Practice address
9300 Valley Childrens PL
Childrens Hospital Central California. Emergency Dept.
Madera, CA 93636-8761
Phone
(559) 353-3000
NPI assigned
Mar 26, 2007
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 42854 TN
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X A99004 CA Primary
Pediatrics Physician 208000000X R5882 TX
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X R5882 TX

Addresses

Primary practice location

9300 Valley Childrens PL
Childrens Hospital Central California. Emergency Dept.
Madera, CA 93636-8761

Mailing address

9952 Briley Way
Villa Park, CA 92861-4200
Phone (714) 501-4882

Other identifiers 1

IdentifierTypeStateIssuer
3000899MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100219000617 CA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4486742046 Reassigns benefits to 3 organizations
I20180307001796 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4486742046 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99004CAMDPediatric Emergency Medicine (Emergency Medicine) Physician
42854TNMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 12, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 12, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Acs Primary Care Physicians Southwest, PA Pediatric Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Pediatric Emergency Medicine Group LLP CurrentSince Nov 15, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 19, 2019 Accepting new patients
Emergency Medicine Specialists of Orange County CurrentSince Feb 1, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Pediatric Emergency Specialists, PC Pediatric Emergency Medicine Past Accepting new patients

Locations

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1083732648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9952 BRILEY WAY",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614200",
            "telephone_number": "714-501-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "CHILDRENS HOSPITAL CENTRAL CALIFORNIA. EMERGENCY DEPT.",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHEHMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-11-29",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "42854",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A99004",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R5882",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "R5882",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000899",
            "state": "TN"
        }
    ],
    "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": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.