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DR. SAM KHALIFIAN MD
NPI 1174926190
Dermatology - Procedural Dermatology in La Mesa, CA

Active since October 05, 2014Opted out of Medicare · through Oct 27, 2027
75/100
CMS Quality Rating
8860 CENTER DR STE 300, LA MESA, CA 91942(619) 462-1670(619) 462-3209 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 3, 2022, Sep 24, 2020, Sep 26, 2019 and 1 more (4 updates tracked since 2018).

About Dr. Sam Khalifian Md NPPES

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

DR. SAM KHALIFIAN MD (NPI 1174926190) is an individual procedural dermatology provider in La Mesa, California, licensed in California (A159219) and active in the NPI registry since October 2014. He has opted out of Medicare through October 27, 2027 and remains eligible to order and refer and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1174926190
Entity TypeIndividualMale
Primary Taxonomy207NS0135X
Provider Legal NameDR. SAM KHALIFIANCredential: MD
Location Address8860 CENTER DR STE 300La Mesa, CA 91942-7001
Mailing Address8860 Center Dr Ste 300La Mesa, CA 91942-7001 · (619) 462-1670 · Fax (619) 462-3209
Phone(619) 462-1670
Fax(619) 462-3209
Sole ProprietorNo
Enumeration DateOctober 5, 2014
Last NPPES UpdateAugust 3, 20224 updates tracked since enumeration
NPPES CertifiedAugust 3, 2022
✔ NPI 1174926190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in CA · A159219
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
Also ListedDermatologyTaxonomy 207N00000X · License A159219 (CA)
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X · License A159219 (CA)
8860 CENTER DR STE 300, La Mesa, CA 91942
Open in Google Maps ↗

Other Names 1

Other Name (5)Dr. Saami Khalifian Md

Secondary Practice Locations 3

Location 155 Fruit St # Bh616Boston, MA 02114-2621 · Phone (617) 726-5254
Location 22001 Santa Monica Blvd Ste 1070Santa Monica, CA 90404-2202 · Phone (310) 917-3376 · Fax (310) 582-6302
Location 3514 N Prospect AveRedondo Beach, CA 90277 · Phone (310) 937-8555 · Fax (310) 937-8556

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Sam Khalifian Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 27, 2025 through October 27, 2027.

Opt-Out Effective DateOctober 27, 2025
Opt-Out In Effect ThroughOctober 27, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91942 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIRA ANN TELLACHE PHYSICIAN ASSISTANT
Physician Assistant
8860 CENTER DR STE 300
LA MESA, CA 91942
San Diego County (619) 462-1670
MAYA FIRSOWICZ MD
Dermatology
8860 CENTER DR STE 300
LA MESA, CA 91942
San Diego County (619) 462-1670

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sam Khalifian's NPI number?

The NPI number for Sam Khalifian is 1174926190. It was assigned to this individual provider in the NPPES registry on October 5, 2014. The provider is also known as Dr. Saami Khalifian MD.

Where is Sam Khalifian located?

Sam Khalifian practices at 8860 Center Dr Ste 300, La Mesa, CA 91942. The listed phone number is (619) 462-1670.

What is Sam Khalifian's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Sam Khalifian enrolled in Medicare?

No. Sam Khalifian has opted out of Medicare through October 27, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Sam Khalifian was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.