Individual provider Active NPI

Rafay Tariq Khan, M.D.

  • Interventional Cardiology Physician
  • Lake Mary, FL
National Provider Identifier
1194258012
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME165341 Issued in FL
Practice address
910 Williston Park PT Ste 1000
Lake Mary, FL 32746-2163
Phone
(407) 833-8028
Fax
(407) 833-8033
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 148112 CA
Cardiovascular Disease Physician 207RC0000X TP719 KY
Interventional Cardiology Physician 207RI0011X 56767 KY
Interventional Cardiology Physician 207RI0011X ME165341 FL Primary

Addresses

Primary practice location

910 Williston Park PT Ste 1000
Lake Mary, FL 32746-2163

Mailing address

770 W Granada Blvd Ste 101
Ormond Beach, FL 32174-5179

Other identifiers 1

IdentifierTypeStateIssuer
7100824510MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220505000761 KY Practitioner - Cardiovascular Disease (Cardiology) 3072886076 Reassigns benefits to 1 organization
I20240516002864 FL Practitioner - Interventional Cardiology 3072886076 Reassigns benefits to 2 organizations
I20240729001153 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3072886076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

Hospital & facility affiliations

  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148112CAMDInternal Medicine Physician
ME165341FLMDInterventional Cardiology Physician
56767KYMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Healthcare Partners, Inc Internal Medicine CurrentSince May 17, 2025 Accepting new patients
University of Louisville Physicians, Inc CurrentSince Jun 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Upson Surgical Associates, LLC CurrentSince Jul 8, 2024 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
Post Acute Specialists of Florida PLLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Upson Family Physicians, LC PastSince Jul 8, 2024 Accepting new patients

Locations

910 Williston Park Pt
Ste 1000
Lake Mary, FL 32746
Phone (407) 803-8028

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

770 W Granada Blvd
Ste 101
Ormond Beach, FL 32174
Phone (386) 231-4519

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

2203 N Lois Ave
Ste 814
Tampa, FL 33607
Phone (813) 505-5060

508 S Habana Ave
Ste 300
Tampa, FL 33609
Phone (813) 877-6770

612 W Gordon St
Ste C
Thomaston, GA 30286
Phone (706) 646-5712

612 W Gordon St
Ste B
Thomaston, GA 30286
Phone (706) 647-9433

612 W Gordon St
Ste E
Thomaston, GA 30286
Phone (706) 647-3030

7752 Solution Ctr
Chicago, IL 60677

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 7

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 4

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1194258012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 101",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WILLISTON PARK PT STE 1000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462163",
            "telephone_number": "407-833-8028",
            "fax_number": "407-833-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RAFAY",
        "middle_name": "TARIQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "148112",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "TP719",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "56767",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME165341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100824510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.