Roya Khodaie

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A153964 Issued in CA

Practice address

81557 Dr Carreon Blvd # B2B3
Indio, CA 92201-5517

Phone

(800) 673-1044

NPI assigned

Jun 11, 2015

Reactivated

Mar 13, 2024

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Interoperability endpoints

• Direct secure messaging: rkhodaie@landmarkhealth-direct.org

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.

• Inland Empire Wellness Medical Group Inc

  • Internal Medicine Physician
  • Indio, CA
  • NPI 1285484907
  NPD Authorized official
• Adonai Family Health Center L.L.C.

  • Medical Specialty Clinic/Center
  • Lewisville, TX
  • NPI 1689892374
  NPD (past)

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1437530862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81557 DR CARREON BLVD # B2B3",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015517",
            "telephone_number": "800-673-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81557 DR CARREON BLVD # B2B3",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015517",
            "telephone_number": "800-673-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAIE",
        "first_name": "ROYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "deactivation_date": "2024-03-01",
        "reactivation_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Katz-Villalobos
• James Lesley Kaufman, RADT
• David Anthony Keesee
• Cody Kennedy, CADC-II, ICADC
• Dilia Kepley
• Kidney Institute of the Desert LLC
• Kimberly Killian, LVN
• Esther Kim
• Evelyn Sungmin Kim, PHARMD
• Hyun Il Kim

• Internal Medicine Physician in Indio, CA
• Providers in Indio, 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 Oct 3, 2024; 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.