Individual provider Active NPI

Jameel John Khan, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Napa, CA
National Provider Identifier
1285077255
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A143447 Issued in CA
Practice address
3421 Villa LN Ste 2B
Napa, CA 94558-3060
Phone
(707) 255-5454
Fax
(707) 255-5411
NPI assigned
Apr 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A143447 CA Primary

Addresses

Primary practice location

3421 Villa LN Ste 2B
Napa, CA 94558-3060

Mailing address

3010 Beard Rd
Napa, CA 94558-3442
Phone (707) 255-8825

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20170920003701 CA Practitioner - Physical Medicine and Rehabilitation 5597053512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (800) 923-4040

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9353 Imperial Hwy
Downey, CA 90242-2812
Phone (562) 657-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143447CAMDMental Health Counselor
A143447CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9400 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-6064

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

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.

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1285077255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BEARD RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583442",
            "telephone_number": "707-255-8825",
            "fax_number": "707-252-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 VILLA LN STE 2B",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583060",
            "telephone_number": "707-255-5454",
            "fax_number": "707-255-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JAMEEL",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A143447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.