Individual provider Active NPI

Raffi John Khechoumian, DPM

  • Foot & Ankle Surgery Podiatrist
  • Sherman Oaks, CA
National Provider Identifier
1124715701
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
6165 Issued in CA
Practice address
4849 Van Nuys Blvd Ste 205a
Sherman Oaks, CA 91403-2110
Phone
(310) 828-0011
NPI assigned
Apr 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 6165 CA Primary
Podiatrist 213E00000X 6165 CA

Addresses

Primary practice location

4849 Van Nuys Blvd Ste 205a
Sherman Oaks, CA 91403-2110

Mailing address

PO Box 841868
Los Angeles, CA 90084-1868

Other practice location 1

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone (310) 478-3711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1660 Feehanville Dr
Suite 450
Mount Prospect, IL 60056-6019

PO Box
Los Angeles, CA 90084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Foot and Ankle Institute a Podiatric Surgical Center Podiatrist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1124715701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841868",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 VAN NUYS BLVD STE 205A",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032110",
            "telephone_number": "310-828-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11301 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900731003",
            "country_code": "US",
            "telephone_number": "310-478-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHECHOUMIAN",
        "first_name": "RAFFI",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "6165",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "6165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.