Individual provider Active NPI

Khurram Mumtaz, M.D.

  • Nephrology Physician
  • Oroville, CA
National Provider Identifier
1093979437
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C153915 Issued in CA
Practice address
2450 Oro Dam Blvd E
Oroville, CA 95966-6052
Phone
(530) 712-2171
Fax
(530) 712-2149
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X C153915 CA Primary

Addresses

Primary practice location

2450 Oro Dam Blvd E
Oroville, CA 95966-6052

Mailing address

2450 Oro Dam Blvd E
Oroville, CA 95966-6052
Phone (530) 712-2171

Other identifiers 1

IdentifierTypeStateIssuer
00354398MedicaidNY

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
I20181203000915 CA Practitioner - Nephrology 2466613336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orohealth Corporation a Non Profit Healthcare SystemGroup PAC ID 4082501192, 126 clinicians

Practice addresses (Care Compare)

2450 Oro Dam Blvd E
Oroville, CA 95966-6052
Phone (530) 538-3171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C153915CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System CurrentSince Jul 14, 2025 Accepting new patients
Coachella Valley Nephrology Inc Nephrology CurrentSince Sep 24, 2018 Accepting new patients

Locations

81719 Doctor Carreon Blvd
Indio, CA 92201
Phone (760) 342-6216

81709 Doctor Carreon Blvd
Ste A
Indio, CA 92201

81719 Doctor Carreon Blvd
Ste A
Indio, CA 92201
Phone (760) 347-0707

43576 Washington St
Ste 100
La Quinta, CA 92253
Phone (760) 347-0707

43576 Washington St
#E100
La Quinta, CA 92253

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2450 Oro Dam Blvd E
Oroville, CA 95966
Phone (530) 712-2128

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 4

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1093979437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 ORO DAM BLVD E",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666052",
            "telephone_number": "530-712-2171",
            "fax_number": "530-712-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ORO DAM BLVD E",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666052",
            "telephone_number": "530-712-2171",
            "fax_number": "530-712-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMTAZ",
        "first_name": "KHURRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "C153915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.