DR. SHADI KHALIL MD, PHD
NPI 1366901688
Dermatology in San Diego, CA

Q: What is Shadi Khalil's NPI number?

The NPI number for Shadi Khalil is 1366901688. It was assigned to this individual provider in the NPPES registry on March 16, 2019.

Q: What is Shadi Khalil's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Shadi Khalil was last updated on August 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since March 16, 2019PECOS EnrolledAccepts Medicare Assignment

15004 INNOVATION DR, SAN DIEGO, CA 92128(858) 605-7808 Get Directions Write a Review

NPPES record last updated: August 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 14, 2025, Aug 8, 2024, Aug 6, 2021 and 1 more (4 updates tracked since 2019).

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About Dr. Shadi Khalil Md, Phd NPPES

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

DR. SHADI KHALIL MD, PHD (NPI 1366901688) is an individual dermatology provider in San Diego, California, licensed in California (A178244) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with New York-presbyterian Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1366901688

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameDR. SHADI KHALILCredential: MD, PHD

Location Address15004 INNOVATION DRSan Diego, CA 92128-3491

Mailing Address10790 Rancho Bernardo RdSan Diego, CA 92127-5705 · (858) 605-7808

Phone(858) 605-7808

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 16, 2019

Last NPPES UpdateAugust 14, 20254 updates tracked since enumeration

NPPES CertifiedAugust 14, 2025

✔ NPI 1366901688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in CA · A178244

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License 330949 (NY)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

15004 INNOVATION DR, San Diego, CA 92128

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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. Shadi Khalil Md, Phd 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 ID446799902

PECOS Enrollment IDI20240828001623, I20250829004264

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

430 services330 patients

Special stained specimen slides to examine tissue, each additional procedure 88341

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

53 services25 patients

Special stained specimen slides to identify organisms including interpretation and report 88312

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

36 services21 patients

Special stained specimen slides to examine tissue, initial procedure 88342

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

36 services32 patients

Pathology examination of tissue using a microscope, moderately low complexity 88304

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

18 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

New York-Presbyterian Hospital

Acute Care Hospitals · New York, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330101

Location525 East 68th StreetNew York, NY 10065 · New York County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92128 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.

Other Providers at the Same Location NPPES 20

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

MS. MARGARET ANN FULLER

Occupational Therapist (Physical Rehabilitation)