Individual provider Active NPI

Sirisat Kaur Khalsa, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Sherman Oaks, CA
National Provider Identifier
1669418182
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
A75010 Issued in CA
Practice address
4849 Van Nuys Blvd Ste 202
Sherman Oaks, CA 91403-2121
Phone
(310) 954-5315
Fax
(310) 496-0430
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A75010 CA
Addiction Medicine (Family Medicine) Physician 207QA0401X A75010 CA Primary

Addresses

Primary practice location

4849 Van Nuys Blvd Ste 202
Sherman Oaks, CA 91403-2121

Mailing address

4849 Van Nuys Blvd Ste 202
Sherman Oaks, CA 91403-2121
Phone (310) 954-5315

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
I20080804000307 CA Practitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - Addiction Medicine 5799859112 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75010CAMDPharmacist
A75010CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mend Health Inc CurrentSince May 2, 2016 Accepting new patients
Executive Recovery Group, Inc Past Accepting new patients
California Recovery Centers LLC Past Accepting new patients
Recovery Grads, LLC Past Accepting new patients
Executive Recovery Group, Inc Past Accepting new patients
Executive Recovery Group, Inc Past Accepting new patients
Executive Recovery Group, Inc Past Accepting new patients
Executive Recovery Group, Inc Past Accepting new patients
Aim Recovery Centers Past Accepting new patients

Locations

13636 Ventura Blvd
Sherman Oaks, CA 91423
Phone (818) 763-9997

4312 Woodman Ave
Ste 102
Sherman Oaks, CA 91423
Phone (818) 205-9366

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1669418182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 VAN NUYS BLVD STE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032121",
            "telephone_number": "310-954-5315",
            "fax_number": "310-496-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 VAN NUYS BLVD STE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032121",
            "telephone_number": "310-954-5315",
            "fax_number": "310-496-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALSA",
        "first_name": "SIRISAT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A75010",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A75010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.