Individual provider Active NPI

Rakesh Khanna, MD

  • Emergency Medicine Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1174598502
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0022820 Issued in FL
Practice address
5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503
Phone
(954) 730-2750
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0022820 FL Primary

Addresses

Primary practice location

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503

Mailing address

PO Box 863481
Orlando, FL 32886-3481

Other identifiers 2

IdentifierTypeStateIssuer
93721OtherFLBCBS
207411700MedicaidFL

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
I20050804000945 FL Practitioner - Internal MedicinePractitioner - Emergency Medicine 8729017215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0022820FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FMC Emergency Solutions LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1174598502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863481",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131503",
            "telephone_number": "954-730-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "RAKESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0022820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "93721",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207411700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.