Active NPI
Adrian J Khaw, MD
- Pediatrics Physician
- Truckee, CA
National Provider Identifier
1144268863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD469282
- Practice address
- 10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234 - Phone
- (415) 424-4266
- Fax
- (415) 520-6633
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 38125 | OK | |
| Pediatrics Physician | 208000000X | D95231 | MD | |
| Pediatrics Physician | 208000000X | T0257 | TX | |
| Pediatrics Physician | 208000000X | 258789 | NY | |
| Pediatrics Physician | 208000000X | 68680 | MN | |
| Pediatrics Physician | 208000000X | ME147496 | FL | |
| Pediatrics Physician | 208000000X | 2021014516 | MO | |
| Pediatrics Physician | 208000000X | 20680 | NV | |
| Pediatrics Physician | 208000000X | DR.0065494 | CO | |
| Pediatrics Physician | 208000000X | 88333 | GA | |
| Pediatrics Physician | 208000000X | 036154818 | IL | |
| Pediatrics Physician | 208000000X | ME95394 | FL | |
| Pediatrics Physician | 208000000X | 286231 | MA | |
| Pediatrics Physician | 208000000X | C170906 | CA | |
| Pediatrics Physician | 208000000X | MD469282 | PA | Primary |
Addresses
Primary practice location
10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234
Mailing address
10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234
Phone (415) 424-4266
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 830095309 | Medicaid | MO | |
| 110568800 | Medicaid | FL | |
| 1144268863 | Medicaid | IL | |
| 250012079 | Medicaid | NV | |
| 9000187587 | Medicaid | CO | |
| 100199977 | Medicaid | CA | |
| 423421301 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C170906 | CA | MD | Pediatrics Physician |
| DR.0065494 | CO | MD | Pediatrics Physician |
| ME147496 | FL | MD | Pediatrics Physician |
| 88333 | GA | MD | Pediatrics Physician |
| 036154818 | IL | MD | Pediatrics Physician |
| 286231 | MA | MD | Pediatrics Physician |
| D95231 | MD | MD | Pediatrics Physician |
| 68680 | MN | MD | Pediatrics Physician |
| 2021014516 | MO | MD | Pediatrics Physician |
| 20680 | NV | MD | Pediatrics Physician |
| 38125 | OK | MD | Pediatrics Physician |
| MD469282 | PA | MD | Pediatrics Physician |
| T0257 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun River Health Inc. | Current | Accepting new patients | |
| Sun River Health Inc | Current | Accepting new patients | |
| Telehealth Services USA | Pediatrics | Past | Accepting new patients |
Locations
3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006
803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700
10504 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 725-5000
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Amenia, NY
- NPI 1568526838
-
- Federally Qualified Health Center (FQHC)
- Peekskill, NY
- NPI 1619969458
-
- Pediatrics Physician
- Truckee, CA
- NPI 1275035263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1144268863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10775 PIONEER TRL STE 215",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961610234",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10775 PIONEER TRL STE 215",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961610234",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAW",
"first_name": "ADRIAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "38125",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D95231",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "T0257",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "258789",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "68680",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME147496",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2021014516",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "20680",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "DR.0065494",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "88333",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036154818",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME95394",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "286231",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C170906",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD469282",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "830095309",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110568800",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144268863",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "250012079",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000187587",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100199977",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "423421301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.