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PROTIVA SHOOPROVA KHAN OD
NPI 1902327240
Optometrist in Mariposa, CA

Active since June 27, 2017PECOS EnrolledAccepts Medicare Assignment
5192 HOSPITAL ROAD, MARIPOSA, CA 95338(209) 742-6144 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 5, 2026, Nov 1, 2021, Feb 20, 2021 and 1 more (4 updates tracked since 2017).

About Protiva Shooprova Khan Od NPPES

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

PROTIVA SHOOPROVA KHAN OD (NPI 1902327240) is an individual optometrist in Mariposa, California, licensed in California (34680) 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 (2017).

NPPES Registry Identity

NPI1902327240
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NamePROTIVA SHOOPROVA KHANCredential: OD
Location Address5192 HOSPITAL ROADMariposa, CA 95338
Mailing Address2912 Willowbrook Dr Apt 3Merced, CA 95348-1301 · (213) 820-6350
Phone(209) 742-6144
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJune 27, 2017
Last NPPES UpdateAugust 5, 20264 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
✔ NPI 1902327240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in CA · 34680✔ Licensed in NY · TUV008592-1
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
5192 HOSPITAL ROAD, Mariposa, CA 95338
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1708 W 20th St Ste AMerced, CA 95340-3697 · Phone (209) 384-2335
Location 21650 Selwyn Ave Apt 1CBronx, NY 10457-7628 · Phone (718) 960-2041

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana.Insurance ›

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

Protiva Shooprova Khan Od 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 ID7810249968
PECOS Enrollment IDI20210318002480
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

2

Medicare enrollment records show Protiva Khan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dr. Matthew B. Lee, O.D. Inc
31 mi
Optometrist
708 W 20TH ST STE A
Merced, CA 95340
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Dr Matthew B Lee Od Inc
  • 2 clinicians in this Medicare group
NPI 1770122061 (209) 384-2335
Southern California Permanente Medical Group
221 mi
Health Maintenance Organization
43112 N 15TH ST
Lancaster, CA 93534
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1982863783 (661) 726-2279

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 95338 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
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
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 Protiva Khan's NPI number?

The NPI number for Protiva Khan is 1902327240. It was assigned to this individual provider in the NPPES registry on June 27, 2017.

Where is Protiva Khan located?

Protiva Khan practices at 5192 Hospital Road, Mariposa, CA 95338. The listed phone number is (209) 742-6144.

What is Protiva Khan's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Protiva Khan enrolled in Medicare?

Yes. Protiva Khan 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 Protiva Khan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Protiva Khan reassigns Medicare benefits to 2 organizations: Dr. Matthew B. Lee, O.D. Inc (Merced, CA) and Southern California Permanente Medical Group (Lancaster, 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 Protiva Khan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Protiva Khan accept?

Health plans from Blue Cross and Blue Shield of Louisiana list Protiva Khan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Protiva Khan was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.