Individual provider Active NPI

Khawla H Suleiman-Qafiti, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1659303121
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A51318 Issued in CA
Practice address
3514 30TH St
San Diego, CA 92104-4120
Phone
(619) 515-2424
NPI assigned
Jul 7, 2006
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A51318 CA Primary

Addresses

Primary practice location

3514 30TH St
San Diego, CA 92104-4120

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other practice location 1

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other identifiers 1

IdentifierTypeStateIssuer
A51318OtherCALIC

Other names 1

  • Khawla Hanna Suleiman Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000353 CA Practitioner - Pediatric Medicine 3274547286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A51318CAMDPediatrics Physician
51318CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Feb 23, 2017 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Feb 23, 2017 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

3514 30th St
San Diego, CA 92104
Phone (619) 515-2424

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

Interoperability endpoints

  • Direct secure messaging: ksuleimanqafiti28347@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1659303121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044120",
            "telephone_number": "619-515-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 Gateway Center Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024541",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULEIMAN-QAFITI",
        "first_name": "KHAWLA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A51318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "A51318",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHAWLA",
            "last_name": "SULEIMAN",
            "middle_name": "HANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.