Alexander Khodak, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME173048 Issued in FL

Practice address

2955 Brownwood Blvd Ste 403
The Villages, FL 32163-2040

Phone

(844) 884-9355

Fax

(352) 674-8714

NPI assigned

Apr 4, 2018

Last updated

Aug 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centerwell Senior Primary Care Vitality IncGroup PAC ID 4486152899, 144 clinicians

The Villages Health System LLCGroup PAC ID 2163667288, 146 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexander.khodak.1@18324.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18324/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1730076621
  Medicare reassignment Care Compare group NPD
• The Villages Health System LLC

  dba The Villages Health

  • General Practice Physician
  • The Villages, FL
  • NPI 1699012922
  Medicare reassignment Care Compare group NPD
• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1457223406
  NPD
• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1801768841
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1023514437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LAKE SUMTER LNDG",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321622699",
            "telephone_number": "352-674-8905",
            "fax_number": "352-674-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 BROWNWOOD BLVD STE 403",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632040",
            "telephone_number": "844-884-9355",
            "fax_number": "352-674-8714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 N US Highway 441 Ste 810",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321598987",
            "country_code": "US",
            "telephone_number": "844-884-9355",
            "fax_number": "352-674-8714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHODAK",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD475270",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME173048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keystone Chiropractic LLC (NJ Chiropractic Coverage Services)
• Imtiaz Ali Khan, DMD
• Uzma Khan, MD
• Dinesh Khanna, M.D.
• Trisha Khanna, M.D.
• Amanda Kay Kiddey, PMHNP-BC, APRN
• Donald O Kim
• Laura Kind
• Brian Kinsey, ARNP
• Rosemary Kipp, ARNP

• Cardiovascular Disease Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.