MEDYA KHAMIS NP
NPI 1639067598
Nurse Practitioner - Family in San Diego, CA
About Medya Khamis Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDYA KHAMIS NP (NPI 1639067598) is an individual family provider in San Diego, California, licensed in California (95033939) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Medya Khamis Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Medya Khamis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92105
- Reassigned Medicare billing, California enrollment
- 102 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92105 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SAN DIEGO, CA 92105
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 Medya Khamis's NPI number?
The NPI number for Medya Khamis is 1639067598. It was assigned to this individual provider in the NPPES registry on June 27, 2025.
Where is Medya Khamis located?
Medya Khamis practices at 4060 Fairmount Ave, San Diego, CA 92105. The listed phone number is (619) 795-5991.
What is Medya Khamis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Medya Khamis enrolled in Medicare?
Yes. Medya Khamis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Medya Khamis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Medya Khamis reassigns Medicare benefits to La Maestra Family Clinic, Inc. (San Diego, 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 Medya Khamis'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 Medya Khamis was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Medya Khamis, NP · NPI 1639067598
Family physician in San Diego, California. Individual provider, active in the CMS NPPES registry since June 27, 2025.
## Identity
- **NPI:** 1639067598 (Entity type: Individual)
- **Enumerated:** June 27, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95033939 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4060 FAIRMOUNT AVE, San Diego, CA 92105-1608
- **Phone:** (619) 795-5991 · **Fax:** (619) 795-5992
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** La Maestra Family Clinic, Inc. (NPI 1609849074, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1639067598) · Data from the CMS NPPES public registry.