Active NPI
Afsaneh Khalili, M.D.
- Internal Medicine Physician
- Sacramento, CA
National Provider Identifier
1326102708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A63303
- Practice address
- 4400 Duckhorn Dr
Sacramento, CA 95834-2589 - Phone
- (916) 575-8000
- Fax
- (916) 575-8099
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A63303 | CA | |
| Internal Medicine Physician | 207R00000X | A63303 | CA | Primary |
Addresses
Primary practice location
4400 Duckhorn Dr
Sacramento, CA 95834-2589
Mailing address
3400 Data Dr
Credentialing
Rancho Cordova, CA 95670-7956
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 954877490 | Other | CA | BLUE CROSS PROVIDER ID |
| 00A633030 | Other | CA | BLUE SHIELD PROVIDER NO. |
| 00A633030 | Other | CA | MEDI-CAL PROVIDER NO. |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040513000403 | CA | Practitioner - Internal Medicine | 9133118250 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1326102708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"address_2": "CREDENTIALING",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 DUCKHORN DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958342589",
"telephone_number": "916-575-8000",
"fax_number": "916-575-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALILI",
"first_name": "AFSANEH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A63303",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A63303",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "954877490",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NO.",
"identifier": "00A633030",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL PROVIDER NO.",
"identifier": "00A633030",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.