Active NPI
Talaksoon Khademi, DO
- Obstetrics & Gynecology Physician
- Exeter, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 20A9077
- Practice address
- 1014 San Juan Ave.
Exeter, CA 93221 - Phone
- (559) 592-7300
- Fax
- (559) 624-6590
- NPI assigned
- May 12, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 20A9077 | CA | Primary |
Addresses
Primary practice location
1014 San Juan Ave.
Exeter, CA 93221
Mailing address
400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629029194 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160322000546 | CA | Practitioner - Obstetrics/Gynecology | 8426055849 |
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2611 N Dinuba Blvd
Visalia, CA 93291-9003
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A9077 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare Network | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Family Healthcare Network | Past | Accepting new patients | |
| Family Healthcare Network | Past | Accepting new patients | |
| Kaweah Delta Health Care District | Past | Accepting new patients | |
| Kaweah Delta Health Care District | Past | Accepting new patients |
Organizations & group practices 7
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.
-
- Obstetrics & Gynecology Physician
- Visalia, CA
- NPI 1598124752
-
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1063283158
-
- Federally Qualified Health Center (FQHC)
- Ivanhoe, CA
- NPI 1386670610
-
- Federally Qualified Health Center (FQHC)
- Three Rivers, CA
- NPI 1558454256
-
dba Kaweah Health Medical Center
- General Acute Care Hospital
- Visalia, CA
- NPI 1588663769
-
dba Kaweah Health Urgent Care
- Urgent Care Clinic/Center
- Visalia, CA
- NPI 1790795458
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kaweah Health Medical Center
- General Acute Care Hospital
- Visalia, CA
- NPI 1588663769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1629029194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W MINERAL KING AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932916237",
"telephone_number": "559-624-2000",
"fax_number": "559-732-9777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 SAN JUAN AVE.",
"city": "EXETER",
"state": "CA",
"postal_code": "93221",
"telephone_number": "559-592-7300",
"fax_number": "559-624-6590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHADEMI",
"first_name": "TALAKSOON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "20A9077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629029194",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Exeter, CA
- Alexis Kapheim, MFTI
- Aaron Josef Kasser
- Simranpreet Kaur
- Kaweah Delta Health Care District (Kaweah Health Exeter Clinic)
- Kealani Sine MD Inc (Pine Street Pediatrics)
- Kimberly Diane Klause-Flores, PSYD, AMFT, APPC, MA
- Tirian Ann Klein, MFTI
- Timothy George Koford, LMFT
- Kronk Chiropractic, Inc.
- Rosio M Laguna
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.