Individual provider Active NPI

Ghiath Kashlan, MD

  • Internal Medicine Physician
  • Trinity, FL
National Provider Identifier
1053393561
Registry record updated Mar 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME106343 Issued in FL
Practice address
8835 Hawbuck St
Trinity, FL 34655-5361
Phone
(813) 792-1900
Fax
(855) 287-7006
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME106343 FL Primary

Addresses

Primary practice location

8835 Hawbuck St
Trinity, FL 34655-5361

Mailing address

17921 Hunting Bow Cir
Suite 101
Lutz, FL 33558-5379
Phone (813) 792-1900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110112000069 FL Practitioner - Internal Medicine 2264492206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17921 Hunting Bow Cir
Suite 101
Lutz, FL 33558-5379
Phone (813) 792-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME106343FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC CurrentSince Feb 11, 2016 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Johnson Memorial Hospital Internal Medicine Past Accepting new patients
Access Healthcare LLC Internal Medicine Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

1516 E Las Olas Blvd
Ft Lauderdale, FL 33301
Phone (954) 356-5142

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

4801 N Howard Ave
Tampa, FL 33603
Phone (727) 581-4800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIBCCA/Endpoint/JIBCCA

Organizations & group practices 6

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364083200000",
    "number": "1053393561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17921 HUNTING BOW CIR",
            "address_2": "SUITE 101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585379",
            "telephone_number": "813-792-1900",
            "fax_number": "855-287-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 HAWBUCK ST",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555361",
            "telephone_number": "813-792-1900",
            "fax_number": "855-287-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHLAN",
        "first_name": "GHIATH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2013-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME106343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.