DR. MOEMEN AHMED KHATTAB MD
NPI 1417698903
Internal Medicine in Thousand Oaks, CA

Q: What is Moemen Khattab's NPI number?

The NPI number for Moemen Khattab is 1417698903. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Q: What is Moemen Khattab's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Moemen Khattab was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 06, 2022PECOS EnrolledAccepts Medicare Assignment

215 W JANSS RD, THOUSAND OAKS, CA 91360(805) 852-9218 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Aug 7, 2025, Jun 26, 2025, Jun 13, 2025 and 3 more (6 updates tracked since 2022).

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About Dr. Moemen Ahmed Khattab Md NPPES

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

DR. MOEMEN AHMED KHATTAB MD (NPI 1417698903) is an individual internal medicine provider in Thousand Oaks, California, licensed in California (197267) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with St Joe Mercy Hospital System Livonia, and maintains a secondary practice location in Fontana.

NPPES Registry Identity

NPI1417698903

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. MOEMEN AHMED KHATTABCredential: MD

Location Address215 W JANSS RDThousand Oaks, CA 91360-1847

Mailing Address215 W Janss RdThousand Oaks, CA 91360-1847 · (805) 852-9218

Phone(805) 852-9218

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 6, 2022

Last NPPES UpdateJune 24, 20266 updates tracked since enumeration

NPPES CertifiedJune 24, 2026

✔ NPI 1417698903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in CA · 197267✔ Licensed in MI · 4301513683

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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

215 W JANSS RD, Thousand Oaks, CA 91360

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Secondary Practice Location 1

Location 19961 Sierra AveFontana, CA 92335-6720 · Phone (833) 574-2273

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. Moemen Ahmed Khattab Md 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 ID9739615808

PECOS Enrollment IDI20250509001988, I20250725003143

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.

Hospital Affiliations CMS Care Compare

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

St Joe Mercy Hospital System Livonia

Acute Care Hospitals · Livonia, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230002

Location36475 Five Mile RoadLivonia, MI 48154 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91360 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

$140.72 typical visit price

range $62.32 – $185.36

Typical copayment $35.18 (range $15.58 – $46.34)

Most-billed visit code 99204

Established Patient

$108.74 typical visit price

range $20.68 – $151.85

Typical copayment $27.18 (range $5.17 – $37.96)

Most-billed visit code 99214

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.

LOS ROBLES RADIOLOGIC ASSOCIATES

Radiology (Diagnostic Radiology)