Shadi Al Khatib, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

117754 Issued in CA

Practice address

450 W Clara St
Oxnard, CA 93033-8363

Phone

(805) 488-0210

Fax

(805) 488-0510

NPI assigned

Apr 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shadial.khatib.p1@direct.clinicas.nextgenshare.com
• Direct secure messaging: skhatib802562@direct.ochin.org

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.

• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Ventura, CA
  • NPI 1679631907
  Medicare reassignment NPD
• Clinicas del Camino Real Inc

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1235866138
  NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Ojai, CA
  • NPI 1316163736
  NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Camarillo, CA
  • NPI 1295297190
  NPD (past)
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Oxnard, CA
  • NPI 1942789359
  NPD (past)

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1386901593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W CLARA ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930338363",
            "telephone_number": "805-488-0210",
            "fax_number": "805-488-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIB",
        "first_name": "SHADI",
        "middle_name": "AL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "117754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Noelle Keyser, MS, LMFT
• Mohamed Khaled, MSD
• Mohammad Naeemullah Khan, M.D.
• Sayeh Neisha Bibi Khan
• Usman Khan
• Manoj Khatore, M.D.
• Khodadadi, Alirezaei and Keihani Dental Corp
• Khoi Dinh Nguyen MD Inc
• Alireza Khoshnoodi
• Alex Kim, OTD

• Pediatrics Physician in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.

Verify at the official NPI Registry.