Khadija H Hamisi, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20560 Issued in CA

Practice address

11801 Pierce St Ste 200
Riverside, CA 92505-4400

Phone

(909) 429-3244

Fax

(909) 981-0821

NPI assigned

Feb 12, 2010

Last updated

May 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Inland Empire Behavioral Group Nursing CorporationGroup PAC ID 4880089390, 4 clinicians

Inland Psychiatric Medical Group IncGroup PAC ID 9436062312, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ABEFCA
• Direct secure messaging: khamisi470824@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inland Empire Behavioral Group Nursing Corporation

  • Multi-Specialty Clinic/Center
  • Riverside, CA
  • NPI 1104570282

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD Authorized official
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1649217761
  Medicare reassignment Care Compare group
• Amygdala Medical Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
  • NPI 1386324267
  Medicare reassignment NPD
• Brainpower Wellness Institute Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
  • NPI 1528573615
  Medicare reassignment NPD
• Shasta Regional Medical Group Inc

  dba Shasta Community Medical Group

  • Hospitalist Physician
  • Redding, CA
  • NPI 1396990545
  Medicare reassignment NPD
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Hesperia, CA
  • NPI 1588091169
  NPD
• Orna Gil MD Inc

  • Obstetrics & Gynecology Physician
  • Redding, CA
  • NPI 1588134423
  NPD
• Shasta Regional Medical Group, Inc

  • Family Medicine Physician
  • Weed, CA
  • NPI 1588048680
  NPD
• Impression Healthcare Services, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Grand Terrace, CA
  • NPI 1487885497
  NPD (past)
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1225360498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 STEINMAN ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077809",
            "telephone_number": "951-906-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 PIERCE ST STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054400",
            "telephone_number": "909-429-3244",
            "fax_number": "909-981-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMISI",
        "first_name": "KHADIJA",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "20560",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "698511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nemat Hamidzada
• Alissa Michelle Hamilton
• Ashley Hamilton, LVN
• Keith Alan Hamilton, MD
• Kenneth Hamilton, MSW, ASW
• Claudia Suur-Ib Hammond
• Jaida Rochelle Hammond
• Joseph Swanzy Hammond
• Mariel Hamor
• Hampton T Gaskins MD Inc

• Psychiatric/Mental Health Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.