Omar Ahmed Khan, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95008495 Issued in CA

Practice address

323 N Prairie Ave
Inglewood, CA 90301-4502

Phone

(310) 846-2100

NPI assigned

Jan 5, 2010

Last updated

Jan 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Didi Hirsch Psychiatric ServiceGroup PAC ID 3870537194, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Didi Hirsch Psychiatric Service

  • Community/Behavioral Health Agency
  • Culver City, CA
  • NPI 1730299959
  Medicare reassignment Care Compare group NPD
• Springs Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1801471982
  Medicare reassignment NPD Authorized official
• Didi Hirsch Psychiatric Service

  • Substance Abuse Rehabilitation Facility
  • Pacoima, CA
  • NPI 1740539980
  NPD

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1629308135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-846-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902304820",
            "country_code": "US",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1465 Kelly Johnson Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809203947",
            "country_code": "US",
            "telephone_number": "719-495-3359",
            "fax_number": "719-691-7003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "OMAR",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0995819-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95008495",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "851513",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000193312",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Vernell Key, R.N.
• Ivrina Marie Keyes, LVN-215505
• Gaurab Khadka, M.D.
• Siamak Khakshooy, D.D.S
• Muhammad Zirik Khan
• David Kheradyar, M.D.
• Azita Kiai, D.C.
• Haein Kim, MD
• Hoon Kim, DO
• Myung Sun Kim

• Psychiatric/Mental Health Nurse Practitioner in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.