Individual provider Active NPI

Sumit Mahendra Khandhar, DO

  • Interventional Cardiology Physician
  • Corona, CA
National Provider Identifier
1174701668
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
20A10557 Issued in CA
Practice address
2250 S Main St Ste 201
Corona, CA 92882-2536
Phone
(951) 734-4880
Fax
(951) 734-7963
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A10557 CA
Cardiovascular Disease Physician 207RC0000X 20A10557 CA
Interventional Cardiology Physician 207RI0011X 20A10557 CA Primary

Addresses

Primary practice location

2250 S Main St Ste 201
Corona, CA 92882-2536

Mailing address

1901 Town and Country Dr Ste 104
Norco, CA 92860-3611
Phone (951) 737-8141

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
I20110207000056 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0547440794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

40663 Murrieta Hot Springs Rd
Suite C1
Murrieta, CA 92562-9015
Phone (951) 200-6791

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12
Varicose vein removal31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10557CAMDContractor
20A10557CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors CurrentSince Nov 1, 2022 Accepting new patients
Circle City Ekg Reading Panel,Inc CurrentSince Mar 1, 2020 Accepting new patients
United Medical Doctors CurrentSince Nov 1, 2022 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Uhs Corona Inc PastSince Jul 1, 2017 Accepting new patients

Locations

380 W Central Ave
Ste 310
Brea, CA 92821
Phone (657) 286-2670

2250 S Main St
Ste 205
Corona, CA 92882
Phone (951) 734-2900

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2250 S Main St
Ste 201
Corona, CA 92882
Phone (951) 621-3232

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

40663 Murrieta Hot Springs Rd
Ste C1
Murrieta, CA 92562
Phone (951) 200-6791

5020 Campus Dr
Ste 200
Newport Beach, CA 92660
Phone (949) 757-1150

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

4244 Riverwalk Pkwy
Ste 290
Riverside, CA 92505
Phone (833) 863-3627

31170 Temecula Pkwy
Ste 100
Temecula, CA 92592
Phone (951) 698-6090

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4
  • Direct secure messaging: skhandhar181984@direct.llu.edu

Organizations & group practices 7

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1174701668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR STE 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611",
            "telephone_number": "951-737-8141",
            "fax_number": "951-738-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822536",
            "telephone_number": "951-734-4880",
            "fax_number": "951-734-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDHAR",
        "first_name": "SUMIT",
        "middle_name": "MAHENDRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10557",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "20A10557",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "20A10557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.