LILY PE KHOSHABA, FNP — NPI 1598986192 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health in WINTON, CA)

CMS-1500 Box 24J / 33a • NPI

1598986192

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LC1500X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health

Box 32 Service Location & ZIP+4

6596 N WINTON WAY, WINTON, CA, 95388-9532

✓ 9-Digit EDI 837 ZIP+4 (95388-9532)

Practice Phone & Referral Fax

(209) 357-7755

Fax: (209) 357-7263

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1598986192 (LILY PE KHOSHABA, FNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1598986192` (NPI-1 Individual Practitioner)
Provider / Legal Name	LILY PE KHOSHABA, FNP
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health NUCC Code: `363LC1500X` (Nurse Practitioner, Community Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6596 N WINTON WAY, WINTON, CA, 95388-9532
Practice Telephone / Fax	Tel: (209) 357-7755 \| Fax: (209) 357-7263
Administrative Mailing Address	6596 N WINTON WAY, WINTON, CA, 95388-9532
Enumeration & Last Sync	Enumerated: 2007-05-01 \| CMS Record Updated: 2014-10-07

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6596 N WINTON WAY, WINTON, CA, 95388-9532

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Plain-English Taxonomy & CMS Crosswalk (363LC1500X)

What Does Taxonomy Code 363LC1500X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LC1500X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Community Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LILY PE KHOSHABA, FNP)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363LC1500X` — Nurse Practitioner, Community Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Community Health	State: CA \| License: `NP13851` \| Primary: Yes (Primary)

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LILY PE KHOSHABA, FNP (NPI #1598986192)