NPIMap

Individual provider Active NPI

Khaldoun A Debian, M.D.

  • Gastroenterology Physician
  • Tustin, CA
National Provider Identifier
1932168796
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A63521 Issued in CA
Practice address
17400 Irvine Blvd Ste F
Tustin, CA 92780-3030
Phone
(714) 937-9400
Fax
(714) 937-9404
NPI assigned
Mar 21, 2006
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A63521 CA Primary

Addresses

Primary practice location

17400 Irvine Blvd Ste F
Tustin, CA 92780-3030

Mailing address

17400 Irvine Blvd Ste F
Tustin, CA 92780-3030
Phone (714) 937-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031211000831 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 6103722830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030
Phone (714) 937-9400

2752 Harrison Ave
Suite a
Eureka, CA 95501-4738
Phone (714) 449-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy159
Upper gastrointestinal (GI) endoscopy for acid reflux194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63521CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2025 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Susan Debin MD Inc. Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Northbay Healthcare Group Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

2752 Harrison Ave
#A
Eureka, CA 95501
Phone (707) 268-0190

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kdebian887786@oc.providencedirect.org
  • Direct secure messaging: khaldoun.debian.p24@direct.monarchhealthcare.nextgenshare.com
  • Direct secure messaging: khaldoun.debian.p4@direct.monarchhealthcare.nextgenshare.com
  • Direct secure messaging: khaldoun.debian.p6@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1932168796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD STE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-937-9400",
            "fax_number": "714-937-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD STE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-937-9400",
            "fax_number": "714-937-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBIAN",
        "first_name": "KHALDOUN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A63521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.