Khadija Eshrath Mayet, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A55134 Issued in CA

Practice address

19066 Magnolia St
Huntington Beach, CA 92646-2232

Phone

(714) 968-0068

NPI assigned

Nov 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

George Washington University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Care Plus Home Health Home health agency, Laguna Hills, CA, CCN 059376
• Providence at Home With Compassus Home Health Orange County Home health agency, Anaheim, CA, CCN 057600
• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
• Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kmayet1373941@oc.providencedirect.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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1801443510
  NPD
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)
• Talbert Medical Group, P.C.

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1528069176
  NPD (past)

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

• Care Plus Nursing Services, Inc.

  • Home Health Agency
  • Laguna Hills, CA
  • NPI 1528385143
  Care Compare affiliation
• CP Orange County S-Ca HH, LLC

  • Home Health Agency
  • Anaheim, CA
  • NPI 1588486716
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation
• Saddleback Memorial Medical Center

  • General Acute Care Hospital
  • Laguna Hills, CA
  • NPI 1275576381
  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1528049665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775600",
            "telephone_number": "949-495-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19066 MAGNOLIA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926462232",
            "telephone_number": "714-968-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYET",
        "first_name": "KHADIJA",
        "middle_name": "ESHRATH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A55134",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmayet1373941@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy Ste 315",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926918039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edna Mauricio
• Ana Paula Gomes Mauro, MA
• Alexander Paul Mauter, OTR/L
• Azita Mavandadi, PHARMD
• Elizabeth Maxwell
• Cammie Mayfield, OTR/L
• Coleen Kay Mayo, P.T.
• Caleb Mays
• MC Sterlingcare Inc.
• Cindy Lee MC Vey, P.T.

• Internal Medicine Physician in Huntington Beach, CA
• Providers in Huntington Beach, 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 Nov 8, 2021; 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.