NPIMap

Individual provider Active NPI

Sanjay Natverlal Khedia, M.D.

  • Internal Medicine Physician
  • Covina, CA
National Provider Identifier
1326063801
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A56166 Issued in CA
Practice address
315 N 3Rd Ave Ste 100
Covina, CA 91723-1901
Phone
(626) 915-7674
Fax
(626) 966-1952
NPI assigned
Jul 13, 2006
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A56166 CA Primary

Addresses

Primary practice location

315 N 3Rd Ave Ste 100
Covina, CA 91723-1901

Mailing address

PO Box 4869
West Covina, CA 91791-0869
Phone (626) 915-7674

Other identifiers 3

IdentifierTypeStateIssuer
A56166OtherCAMEDICAL BOARD OF CALIFORNIA
1326063801OtherNPI
1508172578OtherCANPI (TYPE II ORGANIZATION)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050601001121 CA Practitioner - Internal Medicine 3173566072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

211 W Badillo St
Covina, CA 91723-1907

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A56166CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanjay N. Khedia, M.D., Inc. Internal Medicine CurrentSince Aug 11, 2010 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

211 W Badillo St
Covina, CA 91723
Phone (626) 915-7674

315 N 3rd Ave
Ste 100
Covina, CA 91723
Phone (626) 967-4465

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Emanate Health Inter-Community HospitalCovina, CA, CCN 050382 Hospital Corporate Director Sep 1, 2023
Emanate Health Foothill Presbyterian HospitalGlendora, CA, CCN 050597 Hospital Corporate Director Sep 1, 2023
Emanate Health Inter-Community HospitalCovina, CA, CCN 555610 Skilled nursing facility Corporate Director Sep 1, 2023
Sierra View Care CenterBaldwin Park, CA, CCN 056466 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 30, 2018
Apr 8, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1326063801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4869",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917910869",
            "telephone_number": "626-915-7674",
            "fax_number": "626-966-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N 3RD AVE STE 100",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231901",
            "telephone_number": "626-915-7674",
            "fax_number": "626-966-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEDIA",
        "first_name": "SANJAY",
        "middle_name": "NATVERLAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A56166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A56166",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1326063801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (TYPE II ORGANIZATION)",
            "identifier": "1508172578",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.