DR. NICOLE M KHADAVI M.D.
NPI 1467745851
Student in an Organized Health Care Education/Training Program in Loma Linda, CA
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
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Nicole Khadavi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Anaheim, CA 92807
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
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.
Which organization bills Medicare for Nicole Khadavi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Khadavi reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, CA). 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 Nicole Khadavi'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 Nicole Khadavi was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Dr. Nicole M Khadavi, M.D. · NPI 1467745851
Student in an Organized Health Care Education/Training Program provider in Loma Linda, California. Individual provider, active in the CMS NPPES registry since May 18, 2011.
## Identity
- **NPI:** 1467745851 (Entity type: Individual)
- **Enumerated:** May 18, 2011
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005, Loma Linda, CA 92354-2804
- **Phone:** (818) 621-8585
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1952333460, Anaheim, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, Geffen School Of Medicine, class of 2010
## Record status
- **NPPES last updated:** December 22, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1467745851) · Data from the CMS NPPES public registry.