Individual provider Active NPI

Khamaj Dave, MD

  • Cardiovascular Disease Physician
  • Oxnard, CA
National Provider Identifier
1275594657
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A60040 Issued in CA
Practice address
2241 Wankel Way
Ste C
Oxnard, CA 93030-0190
Phone
(805) 983-0922
Fax
(805) 983-1997
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X A60040 CA
Cardiovascular Disease Physician 207RC0000X A60040 CA Primary

Addresses

Primary practice location

2241 Wankel Way
Ste C
Oxnard, CA 93030-0190

Mailing address

2241 Wankel Way
Ste C
Oxnard, CA 93030-0190
Phone (805) 983-0922

Other identifiers 1

IdentifierTypeStateIssuer
00A60040OtherCABLUESHIELD

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
I20040524001501 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5890776199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Southern California Keck School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cabrillo Cardiology Medical Group IncGroup PAC ID 5890693279, 9 clinicians

Practice addresses (Care Compare)

2241 Wankel Way
Suite C
Oxnard, CA 93030-0191
Phone (805) 351-8212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.51 of 100Reported as group
Quality
79.16
Promoting interoperability
96
Improvement activities
40
Cost
68.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A60040CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cabrillo Cardiology Medical Group Inc. Cardiovascular Disease CurrentSince Apr 1, 2004 Accepting new patients
Dignity Health Past Accepting new patients

Locations

400 Camarillo Ranch Rd
Ste 205
Camarillo, CA 93012
Phone (805) 351-8212

2241 Wankel Way
Ste C
Oxnard, CA 93030
Phone (805) 351-8212

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

Interoperability endpoints

  • Direct secure messaging: khamaj.dave@ccmgi.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHECCA

Organizations & group practices 2

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 1

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1275594657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 WANKEL WAY",
            "address_2": "STE C",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930300190",
            "telephone_number": "805-983-0922",
            "fax_number": "805-983-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 WANKEL WAY",
            "address_2": "STE C",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930300190",
            "telephone_number": "805-983-0922",
            "fax_number": "805-983-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "KHAMAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A60040",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A60040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "00A60040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.