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KHADEER KHAN MSN, DNP, FNP, PMHNP
NPI 1588964456
Nurse Practitioner - Psychiatric/Mental Health in Gardena, CA

Active since October 26, 2010PECOS Enrolled
1875 W REDONDO BEACH BLVD STE 308, GARDENA, CA 90247(310) 387-2054(310) 362-3598 Get Directions Write a Review

NPPES record last updated: November 27, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 5, 2024, Mar 6, 2023, Nov 21, 2022 and 2 more (5 updates tracked since 2020).

About Khadeer Khan Msn, Dnp, Fnp, Pmhnp NPPES

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

KHADEER KHAN MSN, DNP, FNP, PMHNP (NPI 1588964456) is an individual psychiatric/mental health provider in Gardena, California, licensed in California (19864) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS and maintains a secondary practice location in Inglewood.

NPPES Registry Identity

NPI1588964456
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKHADEER KHANCredential: MSN, DNP, FNP, PMHNP
Location Address1875 W REDONDO BEACH BLVD STE 308Gardena, CA 90247-3644
Mailing Address506 Phelan LnRedondo Beach, CA 90278-5309 · (310) 387-2054
Phone(310) 387-2054
Fax(310) 362-3598
Sole ProprietorYes
Enumeration DateOctober 26, 2010
Last NPPES UpdateNovember 27, 20245 updates tracked since enumeration
NPPES CertifiedNovember 27, 2024
✔ NPI 1588964456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 19864
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 19864 (CA)
1875 W REDONDO BEACH BLVD STE 308, Gardena, CA 90247
Open in Google Maps ↗

Secondary Practice Location 1

Location 1301 N Prairie Ave Ste 311Inglewood, CA 90301-4510 · Phone (818) 895-3100 · Fax (310) 981-4064

Other Identifiers 1

Medicaid195UT0EBCA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khadeer Khan Msn, Dnp, Fnp, Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Khadeer Khan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ehab Yacoub MD Inc.
2.2 mi
Child & Adolescent Psychiatry
1225 W 190TH ST STE 280
Gardena, CA 90248
  • Reassigned Medicare billing, California enrollment
  • 375 clinicians in this Medicare group
NPI 1417373713 (310) 515-8113
Mission City Community Network, Inc.
15 mi
Mental Health (Including Community Mental Health Center)
4842 HOLLYWOOD BLVD
Hollywood, CA 90027
  • Reassigned Medicare billing, California enrollment
  • 146 clinicians in this Medicare group
NPI 1710102009 (323) 644-1110
Grow Healthcare Group PC
312 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

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 90247 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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

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

KSK NURSING CORPORATION
Nurse Practitioner (Psychiatric/Mental Health)
1875 W REDONDO BEACH BLVD STE 308
GARDENA, CA 90247
Los Angeles County (310) 387-2054

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 Khadeer Khan's NPI number?

The NPI number for Khadeer Khan is 1588964456. It was assigned to this individual provider in the NPPES registry on October 26, 2010.

Where is Khadeer Khan located?

Khadeer Khan practices at 1875 W Redondo Beach Blvd Ste 308, Gardena, CA 90247. The listed phone number is (310) 387-2054.

What is Khadeer Khan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Khadeer Khan enrolled in Medicare?

Yes. Khadeer Khan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Khadeer Khan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khadeer Khan reassigns Medicare benefits to 3 organizations: Ehab Yacoub MD Inc. (Gardena, CA), Mission City Community Network, Inc. (Hollywood, CA) and Grow Healthcare Group PC (San Jose, 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 Khadeer Khan'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 Khadeer Khan was last updated on November 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.