DR. NIDAL KHAJA D.P.M. - NPI 1013177633 - Podiatrist in Gardena, CA

Q: What is the provider's specialty?

The provider's specialty is Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

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About Dr. Nidal Khaja D.p.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NIDAL KHAJA D.P.M. (NPI 1013177633) is an individual foot & ankle surgery provider in Gardena, California, licensed in California (E4807) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS and is a graduate of California School Of Podiatric Medicine (2005).

NPPES Registry Identity

NPI1013177633

Entity TypeIndividualFemale

Primary Taxonomy213ES0103X

Provider Legal NameDR. NIDAL KHAJACredential: D.P.M.

Location Address1246 W 155TH STGardena, CA 90247-4011

Mailing Address955 Deep Valley Dr, # 4055Palos Verdes Peninsula, CA 90274-3876 · (310) 538-1110 · Fax (310) 538-0929

Phone(310) 768-2256

Fax(310) 323-0914

Sole ProprietorYes

Medical School CMSCalifornia School Of Podiatric MedicineGraduated 2005

Enumeration DateJune 17, 2008

Last NPPES UpdateOctober 21, 2021

NPPES CertifiedOctober 21, 2021

✔ NPI 1013177633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

Licenses✔ Licensed in CA · E4807✔ Licensed in CA · EL1636

1246 W 155TH ST, Gardena, CA 90247

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nidal Khaja D.p.m. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577737121

PECOS Enrollment IDI20111117000474

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.