Individual provider Active NPI

Khalid George, M.D.

  • Gastroenterology Physician
  • Titusville, FL
National Provider Identifier
1275965287
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME137710 Issued in FL
Practice address
825 Century Medical Dr Ste a
Titusville, FL 32796-2113
Phone
(321) 268-6868
Fax
(321) 268-6895
NPI assigned
Jul 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 4301103814 MI
Gastroenterology Physician 207RG0100X ME137710 FL Primary

Addresses

Primary practice location

825 Century Medical Dr Ste a
Titusville, FL 32796-2113

Mailing address

805 Century Medical Dr Ste C
Titusville, FL 32796-2100
Phone (321) 268-6264

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
I20190710000298 FL Practitioner - Gastroenterology 5991937781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc CurrentSince Jul 1, 2019 Accepting new patients
North Brevard Medical Support, Inc Gastroenterology PastSince Aug 8, 2021 Accepting new patients

Locations

825 Century Medical Dr
Ste A
Titusville, FL 32796
Phone (321) 268-6224

805 Century Medical Dr
Ste C
Titusville, FL 32796
Phone (321) 268-6264

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

825 Century Medical Dr
Titusville, FL 32796
Phone (321) 567-4991

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1275965287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CENTURY MEDICAL DR STE C",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962100",
            "telephone_number": "321-268-6264",
            "fax_number": "321-268-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CENTURY MEDICAL DR STE A",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962113",
            "telephone_number": "321-268-6868",
            "fax_number": "321-268-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KHALID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301103814",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME137710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.