NPIMap

Individual provider Active NPI

Rola Khedraki, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • La Jolla, CA
National Provider Identifier
1326466707
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
A140216 Issued in CA
Practice address
9898 Genesee Ave
La Jolla, CA 92037-1205
Phone
(858) 824-5073
Fax
(858) 964-3117
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A140216 CA
Cardiovascular Disease Physician 207RC0000X A140216 CA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X A140216 CA Primary

Addresses

Primary practice location

9898 Genesee Ave
La Jolla, CA 92037-1205

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 824-5073

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
I20210720002935 CA Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1951607746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Vermont College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140216CAMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine CurrentSince Aug 11, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Aug 11, 2021 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

101 The City Dr S
Ste 400
Orange, CA 92868
Phone (714) 456-5691

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: rkhedraki34914@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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 2

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1326466707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-824-5073",
            "fax_number": "858-964-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9898 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-824-5073",
            "fax_number": "858-964-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEDRAKI",
        "first_name": "ROLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A140216",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A140216",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "CA",
            "license": "A140216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.