Haneen Abdussalam Khamag, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A127351 Issued in CA

Practice address

11165 Sepulveda Blvd
Mission Hills, CA 91345-1113

Phone

(818) 837-5785

Fax

(818) 898-1842

NPI assigned

Jul 20, 2011

Last updated

Jan 7, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Internal Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: hkhamag448014@oc.providencedirect.org
• FHIR API: https://fhir4.healow.com/fhir/r4/ABEFCA

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.

• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment Care Compare group NPD
• Shasta Regional Medical Group Inc

  dba Shasta Community Medical Group

  • Hospitalist Physician
  • Redding, CA
  • NPI 1396990545
  Medicare reassignment NPD
• Orna Gil MD Inc

  • Obstetrics & Gynecology Physician
  • Redding, CA
  • NPI 1588134423
  NPD
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Shasta Regional Medical Group, Inc

  • Family Medicine Physician
  • Weed, CA
  • NPI 1588048680
  NPD
• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  NPD (past)
• Providence Health System - Southern California

  dba Providence Holy Cross Medical Center

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  NPD (past)

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

• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  Care Compare affiliation

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1346538683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451113",
            "telephone_number": "818-837-5785",
            "fax_number": "818-898-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMAG",
        "first_name": "HANEEN",
        "middle_name": "ABDUSSALAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "248851",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A127351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1273510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "248851",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rohit R Kedia, D.O.
• Sarah Elizabeth Kees, MSN, RN, AGACNP-BC
• Esther Keiser, RN
• Ariella Kerendian, DDS
• Lucine Khachtourians, MA, LMFT124909
• Elma Khechemyan
• Rania Khoukaz, M.D.
• Jamal Elias Khoury, D.C.
• Kidney Consultants Medical Group, Inc
• Danny Kim, M.D.

• Internal Medicine Physician in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.