DR. NIDAL KHAJA (D.P.M.) – Foot & Ankle Surgery Podiatrist, NPI 1013177633
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,833 PODIATRY in CA
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Provider Addresses for DR. NIDAL KHAJA (D.P.M.)
955 DEEP VALLEY DR
# 4055
PALOS VERDES PENINSULA, CA 902743876
Phone: (310) 538-1110
Fax: (310) 538-0929
Type: Mailing
Kindred Hospital South Bay, 1246, West 155th Street, Gardena, Los Angeles County, California, 90247, United States
GARDENA, CA 902474011
Phone: (310) 768-2256
Fax: (310) 323-0914
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111117000474 | I | Podiatry | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90274)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | OH | |
| Nurse Practitioner | CA | |
| Internal Medicine | CA | |
| Internal Medicine | CA | |
| Internal Medicine, Gastroenterology | CA | |
| Physician Assistant | CA | |
| Emergency Medicine | NC | |
| O P H T H A L M O L O G Y | CA | |
| Anesthesiology, Pain Management | NH | |
| Family Practice, Sports Medicine | CA |
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