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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KHAINGTHAZIN SAN MD
NPI 1508387630
Internal Medicine - Endocrinology, Diabetes & Metabolism in Modesto, CA

Active since June 28, 2017PECOS Enrolled
600 COFFEE RD, MODESTO, CA 95355(209) 550-4755 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 3, 2025, Jan 25, 2023, Apr 14, 2022 and 1 more (4 updates tracked since 2017).

About Khaingthazin San Md NPPES

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

KHAINGTHAZIN SAN MD (NPI 1508387630) is an individual endocrinology, diabetes & metabolism provider in Modesto, California, licensed in California (A167089) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1508387630
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameKHAINGTHAZIN SANCredential: MD
Location Address600 COFFEE RDModesto, CA 95355-4201
Mailing AddressPo Box 255228Sacramento, CA 95865-5228
Phone(209) 550-4755
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateJune 28, 2017
Last NPPES UpdateOctober 23, 20264 updates tracked since enumeration
NPPES CertifiedOctober 23, 2026
✔ NPI 1508387630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in CA · A167089
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
600 COFFEE RD, Modesto, CA 95355
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12601 Ocean PkwyBrooklyn, NY 11235-7745 · Phone (718) 616-3000
Location 21545 Atlantic AveBrooklyn, NY 11213-1122 · Phone (171) 861-3400

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

Khaingthazin San 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 ID2264786805
PECOS Enrollment IDI20230802002662
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 Reassignments

3

Medicare enrollment records show Khaingthazin San reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sutter Valley Medical Foundation
Same address
Multi-Specialty
600 COFFEE RD
Modesto, CA 95355
  • Reassigned Medicare billing, California enrollment
  • 3,056 clinicians in this Medicare group
NPI 1669846986 (209) 524-1211
Golden Valley Health Centers
1.2 mi
Federally Qualified Health Center (FQHC)
209 KERR AVE
Modesto, CA 95354
  • Reassigned Medicare billing, California enrollment
  • 440 clinicians in this Medicare group
NPI 1568939205 (209) 576-6766
Permanente Medical Group Inc
31 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95355 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

RADHA CHIRUMAMILLA M.D.
Hospitalist
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
CYRUS M RABII MD
Emergency Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 521-6097
RONALD D. JENSEN DPM
Podiatrist
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
WALLACE B CARROLL MD
Allergy & Immunology (Allergy)
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
PALLAVI SHARMA MD
Family Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 521-6097
SWE THAN M.D.,PH.D
Internal Medicine
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 550-4702
VIVIAN L TAN M.D.
Anesthesiology
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211
KENNETH IMANAKA MD
Anesthesiology
600 COFFEE RD
MODESTO, CA 95355
Stanislaus County (209) 524-1211

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 Khaingthazin San's NPI number?

The NPI number for Khaingthazin San is 1508387630. It was assigned to this individual provider in the NPPES registry on June 28, 2017.

Where is Khaingthazin San located?

Khaingthazin San practices at 600 Coffee Rd, Modesto, CA 95355. The listed phone number is (209) 550-4755.

What is Khaingthazin San's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Khaingthazin San enrolled in Medicare?

Yes. Khaingthazin San 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 organizations bill Medicare for Khaingthazin San's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khaingthazin San reassigns Medicare benefits to 3 organizations: Sutter Valley Medical Foundation (Modesto, CA), Golden Valley Health Centers (Modesto, CA) and Permanente Medical Group Inc (Stockton, CA). Each 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 Khaingthazin San'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 Khaingthazin San was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.