Organization Active NPI

Manoj Khatore MD a Professional Corporation

  • Cardiovascular Disease Physician
  • Oxnard, CA
National Provider Identifier
1427233923
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MANOJ KHATORE MD A PROFESSIONAL CORPORATION
Practice address
1901 Outlet Center Dr Ste 260
Oxnard, CA 93036-0667
Phone
(805) 604-1824
NPI assigned
Jan 2, 2008
Last updated
Nov 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Manoj Khatore, MDNPI 1528140639
Title
President
Phone
(805) 604-1824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1901 Outlet Center Dr Ste 260
Oxnard, CA 93036-0667

Mailing address

1901 Outlet Center Dr Ste 260
Oxnard, CA 93036-0667
Phone (805) 604-1824

Other identifiers 1

IdentifierTypeStateIssuer
00A653480MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141124000278 CA Part B Supplier - Clinic/Group Practice 3072835305 Receives reassigned benefits from 1 practitioner
Practice locations: Oxnard, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0979069Manoj Khatore MD, a Professional Corporation1901 Outlet Center Drive, Suite #260, Oxnard, CA 93036Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

1901 Outlet Center Dr
Ste 260
Oxnard, CA 93036
Phone (805) 604-1824

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1427233923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 OUTLET CENTER DR STE 260",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360667",
            "telephone_number": "805-604-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 OUTLET CENTER DR STE 260",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360667",
            "telephone_number": "805-604-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOJ KHATORE MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "KHATORE",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-604-1824",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A653480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.