DR. NICOLE M KHADAVI M.D.
NPI 1467745851
Student in an Organized Health Care Education/Training Program in Loma Linda, CA

Active since May 18, 2011PECOS EnrolledAccepts Medicare Assignment
11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354(818) 621-8585 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 22, 2021, Jun 10, 2020 (2 updates tracked since 2020).

About Dr. Nicole M Khadavi M.d. NPPES

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

DR. NICOLE M KHADAVI M.D. (NPI 1467745851) is an individual student in an organized health care education/training program in Loma Linda, California and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (2010).

NPPES Registry Identity

NPI1467745851
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. NICOLE M KHADAVICredential: M.D.
Location Address11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005Loma Linda, CA 92354-2804
Mailing Address11234 Anderson St, Llumc, House Staff Office Cp 21005Loma Linda, CA 92354-2804
Sole ProprietorNo
Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 2010
Enumeration DateMay 18, 2011
Last NPPES UpdateDecember 22, 20212 updates tracked since enumeration
NPPES CertifiedDecember 22, 2021
NPI 1467745851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11234 ANDERSON ST, Loma Linda, CA 92354

Other Names 1

Former Name (1)Nicole Khadavi Kohan M.d.

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. Nicole M Khadavi M.d. 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 ID749405637
PECOS Enrollment IDI20140709001562
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.

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.

Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
General Practice
11234 ANDERSON ST
LOMA LINDA, CA 92354
Preventive Medicine (Occupational Medicine)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92354
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Anesthetist, Certified Registered
11234 ANDERSON ST
LOMA LINDA, CA 92354

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 Nicole Khadavi's NPI number?

The NPI number for Nicole Khadavi is 1467745851. It was assigned to this individual provider in the NPPES registry on May 18, 2011. The provider is also known as Nicole Khadavi Kohan M.D..

Where is Nicole Khadavi located?

Nicole Khadavi practices at 11234 Anderson St Llumc, House Staff Office Cp 21005, Loma Linda, CA 92354. The listed phone number is (818) 621-8585.

What is Nicole Khadavi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicole Khadavi enrolled in Medicare?

Yes. Nicole Khadavi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nicole Khadavi was last updated on December 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.