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JANNIKA DODGE KHATAMI M.D.
NPI 1366845307
Pediatrics - Pediatric Cardiology in Bay Shore, NY

Active since October 05, 2014PECOS Enrolled
376 E MAIN ST STE 102, BAY SHORE, NY 11706(631) 539-5400 Get Directions Write a Review

NPPES record last updated: February 25, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 25, 2021, Dec 7, 2020, May 1, 2018 (3 updates tracked since 2018).

About Jannika Dodge Khatami M.d. NPPES

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

JANNIKA DODGE KHATAMI M.D. (NPI 1366845307) is an individual pediatric cardiology provider in Bay Shore, New York, licensed in New York (292026) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1366845307
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameJANNIKA DODGE KHATAMICredential: M.D.
Location Address376 E MAIN ST STE 102Bay Shore, NY 11706-8441
Mailing Address376 E Main St Ste 102Bay Shore, NY 11706-8441 · (631) 539-5400
Phone(631) 539-5400
Sole ProprietorYes
Enumeration DateOctober 5, 2014
Last NPPES UpdateFebruary 25, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2021
✔ NPI 1366845307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in NY · 292026
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
376 E MAIN ST STE 102, Bay Shore, NY 11706
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12500 N State St, PediatricsJackson, MS 39216-4500 · Phone (601) 815-2005
Location 26410 Fannin St Ste 500Houston, TX 77030-3005 · Phone (832) 325-6516 · Fax (713) 512-2222

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jannika Dodge Khatami M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jannika Dodge Khatami reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Medical PC
24 mi
Internal Medicine
270-05 76TH AVE
New Hyde Park, NY 11040
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1790043479 (516) 465-8089

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 Jannika Dodge Khatami's NPI number?

The NPI number for Jannika Dodge Khatami is 1366845307. It was assigned to this individual provider in the NPPES registry on October 5, 2014.

Where is Jannika Dodge Khatami located?

Jannika Dodge Khatami practices at 376 E Main St Ste 102, Bay Shore, NY 11706. The listed phone number is (631) 539-5400.

What is Jannika Dodge Khatami's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Jannika Dodge Khatami enrolled in Medicare?

Yes. Jannika Dodge Khatami is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jannika Dodge Khatami's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jannika Dodge Khatami reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The 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 Jannika Dodge Khatami's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jannika Dodge Khatami was last updated on February 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.