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PEGAH KHAIROLOMOUR MD
NPI 1689769176
Pediatrics in Auburn, CA

Active since October 03, 2006PECOS Enrolled
3288 BELL ROAD, AUBURN, CA 95603(530) 886-2300(530) 886-2301 Get Directions Write a Review

NPPES record last updated: June 1, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Pegah Khairolomour Md NPPES

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

PEGAH KHAIROLOMOUR MD (NPI 1689769176) is an individual pediatrics provider in Auburn, California, licensed in California (A69773) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689769176
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NamePEGAH KHAIROLOMOURCredential: MD
Location Address3288 BELL ROADAuburn, CA 95603
Mailing Address10470 Old Placerville Rd, Suite 100Sacramento, CA 95827-2539 · (800) 470-0071
Phone(530) 886-2300
Fax(530) 886-2301
Sole ProprietorNo
Enumeration DateOctober 3, 2006
Last NPPES UpdateJune 1, 2015
✔ NPI 1689769176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A69773
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3288 BELL ROAD, Auburn, CA 95603
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Other Identifiers 3

Medicare ID-Type Unspecified00A697730
Medicare UPINH37198
Medicaid00A697730CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pegah Khairolomour Md 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 Reassignment

Medicare enrollment records show Pegah Khairolomour reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Medical Foundation
27 mi
Diagnostic Radiology
2800 L ST FL 7
Sacramento, CA 95816
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Sutter Valley Medical Foundation
  • 3,056 clinicians in this Medicare group
NPI 1942524095 (916) 731-7857

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 95603 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

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 Pegah Khairolomour's NPI number?

The NPI number for Pegah Khairolomour is 1689769176. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Pegah Khairolomour located?

Pegah Khairolomour practices at 3288 Bell Road, Auburn, CA 95603. The listed phone number is (530) 886-2300.

What is Pegah Khairolomour's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Pegah Khairolomour enrolled in Medicare?

Yes. Pegah Khairolomour is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Pegah Khairolomour's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pegah Khairolomour reassigns Medicare benefits to Sutter Medical Foundation (Sacramento, 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 Pegah Khairolomour'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 Pegah Khairolomour was last updated on June 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.