KHAKWANI MEDICAL CORPORATION, PC
NPI 1235851510
Family Medicine in Las Vegas, NV
About Khakwani Medical Corporation, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KHAKWANI MEDICAL CORPORATION, PC (NPI 1235851510), doing business as Pds Medical Group Shadow Mountain, is a healthcare organization registered as a family medicine in Las Vegas, Nevada and active in the NPI registry since September 2022. The organization lists Valerie Denise Estrada, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Khakwani Medical Corporation, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Khakwani Medical Corporation, PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (15)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Khakwani Medical Corporation, PC's NPI number?
The NPI number for Khakwani Medical Corporation, PC is 1235851510. It was assigned to this organization in the NPPES registry on September 14, 2022. The provider is doing business as PDS Medical Group Shadow Mountain.
Where is Khakwani Medical Corporation, PC located?
Khakwani Medical Corporation, PC is located at 6525 N Decatur Blvd Ste 150B, Las Vegas, NV 89131. The listed phone number is (702) 979-5903.
What is Khakwani Medical Corporation, PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Khakwani Medical Corporation, PC enrolled in Medicare?
Yes. Khakwani Medical Corporation, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Khakwani Medical Corporation, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 2 Medicare specialties reassign their Medicare billing to Khakwani Medical Corporation, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (13) and Family Practice (2). Of these, 1 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Khakwani Medical Corporation, PC was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Khakwani Medical Corporation, Pc · NPI 1235851510
Family Medicine organization in Las Vegas, Nevada. Organization record, active in the CMS NPPES registry since September 14, 2022.
## Identity
- **NPI:** 1235851510 (Entity type: Organization)
- **Enumerated:** September 14, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** PDS Medical Group Shadow Mountain (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Valerie Estrada, CREDENTIALING MANAGER
## Practice location
- **Address:** 6525 N DECATUR BLVD STE 150B, Las Vegas, NV 89131-2993
- **Phone:** (702) 979-5903 · **Fax:** (702) 984-7315
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 15 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (13), Family Practice (2); 1 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1235851510) · Data from the CMS NPPES public registry.