Shawn B Khademi, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO61142698 Issued in WA

Practice address

4300 Talbot Rd S Ste 102
Renton, WA 98055-6238

Phone

(425) 277-3668

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Foot and Ankle Center PSGroup PAC ID 6305736067, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Northwest Foot & Ankle Center, PS

  • Podiatrist
  • Renton, WA
  • NPI 1346265261

  Single Specialty, WA

  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • Prosthetic/Orthotic Supplier
  • Lake Geneva, WI
  • NPI 1710124698
  NPD (past)

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1124412184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "425-277-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "425-277-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADEMI",
        "first_name": "SHAWN",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005850",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "1348",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO61142698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Kern, A.R.N.P.
• Celina Kershner, HOME CARE PROVIDER
• Deborah Jean Ketterer, D.P.M.
• Kevin P. Huynh DDS PLLC
• Key Hearing PLLC
• Souchinda Viradet Khampradith, LICSW
• Melany Khamsitthisack, RN
• Dua Naveed Khan, DO
• Lubna Khan, MD
• Ramsha Khan

• All providers in Renton, WA
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.