NPIMap

Individual provider Active NPI

Rahul Khetan, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1225425291
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
S4009 Issued in TX
Practice address
6431 Fannin St
Suite MSB 2.116
Houston, TX 77030-1501
Phone
(713) 500-7640
Fax
(713) 500-7647
NPI assigned
Apr 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X S4009 TX Primary

Addresses

Primary practice location

6431 Fannin St
Suite MSB 2.116
Houston, TX 77030-1501

Mailing address

6431 Fannin St
Suite MSB 2.116
Houston, TX 77030-1501
Phone (713) 500-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL, KY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200508001872 TX Practitioner - Diagnostic Radiology 6002122454 Reassigns benefits to 2 organizations
I20221130000008 FL Practitioner - Diagnostic Radiology 6002122454 Reassigns benefits to 2 organizations
I20230425000722 KY Practitioner - Diagnostic Radiology 6002122454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

1026 Foxhall Dr
Rockwall, TX 75087-6549
Phone (407) 200-2355

1480 W Orange Blossom TRL
Adventhealth Imaging Apopka
Apopka, FL 32712-2637
Phone (407) 200-5440

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

2200 Fowler Grove Blvd
Suite 60
Winter Garden, FL 34787-5597
Phone (407) 200-0538

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

2488 E Irlo Bronson Memorial Hwy
Ahi Partin Settlement
Kissimmee, FL 34744-4948
Phone (407) 200-5440

25 S Terry Ave
Suite 220
Orlando, FL 32805-1843
Phone (407) 641-2446

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S4009TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Radiology Imaging at Lake Mary LLC Diagnostic Radiology CurrentSince Aug 29, 2022 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Aug 29, 2022 Accepting new patients

Locations

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rkhetan795320@adventhealth.direct-ci.com

Organizations & group practices 3

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 7

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1225425291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE MSB 2.116",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7640",
            "fax_number": "713-500-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE MSB 2.116",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7640",
            "fax_number": "713-500-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETAN",
        "first_name": "RAHUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "S4009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.