DR. ANGELA KHAKSHOOY (O.D.) – Optometrist, NPI 1013247212

DR. ANGELA KHAKSHOOY (O.D.) is a healthcare provider. based in Henderson, Nevada. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 13893 (CA). The NPI Number for DR. ANGELA KHAKSHOOY (O.D.) is 1013247212

Main info

Female
17 Years Of Experience
Name
DR. ANGELA KHAKSHOOY (O.D.)
NPI
1013247212
Phone
(702) 565-7579
Address
61 E LAKE MEAD PKWY
Enumeration Date
11 January 2010
Last Update Date
22 October 2024

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
7025657576
Graduation Year
2009 (17 years ago)
PAC ID
1759411077
Group Practice PAC ID
3476630369
Professional Enrollment ID
I20140718000788
Address ID
NV890155531HE61XXXPKWY500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:16State licenses:1Digital endpointsOther names

386 OPTOMETRY in NV

Provider Addresses for DR. ANGELA KHAKSHOOY (O.D.)

  • 61 E LAKE MEAD PKWY

    HENDERSON, NV 890155531

    Phone: (702) 565-7579

    Type: Mailing

  • 425 W BONITA AVE STE 110B

    SAN DIMAS, CA 917732543

    Phone: (909) 394-0462

    Fax: (909) 394-0014

    Type: Location

  • 2703 PEEKSKILL AVE

    HENDERSON, NV 890523844

    Phone: (310) 804-4468

    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: 2014-07-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140718000788IOptometryNVTBD

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.

Verify on CMS Revalidation Lookup Tool

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 89015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476630369View full group profile

Reviews

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Frequently asked questions

Is DR. ANGELA KHAKSHOOY (O.D.) listed with a National Provider Identifier?
Yes — DR. ANGELA KHAKSHOOY (O.D.) has NPI 1013247212 on file in the registry.
Active or inactive — what applies to DR. ANGELA KHAKSHOOY (O.D.)?
You should see DR. ANGELA KHAKSHOOY (O.D.) as active in CMS-hosted NPPES data.
How would a patient describe DR. ANGELA KHAKSHOOY (O.D.)'s focus?
For DR. ANGELA KHAKSHOOY (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. ANGELA KHAKSHOOY (O.D.) located near Henderson?
DR. ANGELA KHAKSHOOY (O.D.) currently maps to Henderson, Nevada in this extract.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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