DR. ABDALLAH KHOURDAJI (MD) – Dermatology Physician, NPI 1093799652
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,140 DERMATOLOGY in CA
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Provider Addresses for DR. ABDALLAH KHOURDAJI (MD)
801, South Ham Lane, Lodi, San Joaquin County, California, 95242, United States
STE A
LODI, CA 952427501
Phone: (209) 333-6110
Fax: (209) 333-0724
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 174 Open Payments records for all available years, with a total value of $2,995.
Total Amount is formed as General ($2,995) + Research ($0) + Ownership ($0) = $2,995.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($666).
Total Amount
$2,995
General + Research + Ownership
Payments
174
Total payment records
General Amount
$2,995
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $666 |
| Janssen Biotech, Inc. | $553 |
| Novartis Pharmaceuticals Corporation | $176 |
| E.R. Squibb & Sons, L.L.C. | $154 |
| Incyte Corporation | $132 |
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: 2005-06-07
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 |
|---|---|---|---|---|
| I20050607000742 | I | Dermatology | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 2,018 | 346 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 777 | 500 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 746 | 481 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 645 | 428 | $0 |
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 305 | 240 | $0 |
Insurance plans in this area (ZIP 95242)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WI | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| O T O L A R Y N G O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | GA | |
| D E R M A T O L O G Y | CA |
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