Individual provider Active NPI

Prerna Mona Khanna, MD

  • Occupational Medicine Physician
  • Palm Springs, CA
National Provider Identifier
1841472826
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
G75180 Issued in CA
Practice address
1180 N Indian Canyon Dr
Ste W200
Palm Springs, CA 92262-4800
Phone
(214) 629-0339
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M130 TX
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X M130 TX
Public Health & General Preventive Medicine Physician 2083P0901X M130 TX
Independent Medical Examiner Physician 202C00000X G75180 CA
Independent Medical Examiner Physician 202C00000X 036-089965 IL
Independent Medical Examiner Physician 202C00000X M130 TX
Internal Medicine Physician 207R00000X 036-089965 IL
Occupational Medicine Physician 2083X0100X 036-089965 IL
Public Health & General Preventive Medicine Physician 2083P0901X 036-089965 IL
Occupational Medicine Physician 2083X0100X G75180 CA Primary
Public Health & General Preventive Medicine Physician 2083P0901X G75180 CA
Occupational Medicine Physician 2083X0100X M130 TX
Public Health or Welfare Agency 251K00000X 036-089965 IL
Internal Medicine Physician 207R00000X G75180 CA

Addresses

Primary practice location

1180 N Indian Canyon Dr
Ste W200
Palm Springs, CA 92262-4800

Mailing address

80254 Jasper Park Ave
Indio, CA 92201-0821
Phone (214) 629-0339

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
I20160129001134 CA Practitioner - Internal Medicine 8224331962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1180 N Indian Canyon Dr
Suite W200
Palm Springs, CA 92262-4876
Phone (214) 629-0339

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M130TXMDIndependent Medical Examiner Physician
G75180CAMDPublic Health & General Preventive Medicine Physician
036-089965ILMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prerna Mona Khanna MD PC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

1180 N Indian Canyon Dr
Ste W200
Palm Springs, CA 92262
Phone (214) 629-0339

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1841472826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80254 JASPER PARK AVE",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010821",
            "telephone_number": "214-629-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "STE W200",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "214-629-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "PRERNA",
        "middle_name": "MONA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M130",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "TX",
            "license": "M130",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "M130",
            "primary": false
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "CA",
            "license": "G75180",
            "primary": false
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "IL",
            "license": "036-089965",
            "primary": false
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "TX",
            "license": "M130",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-089965",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "036-089965",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "036-089965",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "G75180",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "G75180",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "M130",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "IL",
            "license": "036-089965",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.