Khaled R Magdy, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME130058 Issued in FL

Practice address

1893 Kingsley Ave Ste C
Orange Park, FL 32073-4421

Phone

(904) 276-2044

Fax

(904) 276-2106

NPI assigned

Aug 22, 2005

Last updated

Jan 23, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

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

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Clay County Hospital, Middleburg, FL, CCN 100321

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khaled.magdy.1@8967.direct.athenahealth.com

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

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  Pulmonary Disease

  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• St. Vincent's Medical Center-Clay County, Inc.

  dba Ascension St. Vincent's Clay County

  • General Acute Care Hospital
  • Middleburg, FL
  • NPI 1457690471
  Care Compare affiliation

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1346232691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE STE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734421",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE STE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734421",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDY",
        "first_name": "KHALED",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35076302",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME130058",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35076302",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME130058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "0000000391000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4800424",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119728",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Earlon Maddox, APRN
• Linda C Maddox, PT
• Tara Maddox
• Dinesh Madhok, M.D.
• Ishaan Kambo Madhok
• Reuben Kyle Maggard, M.D.
• Magnolia Care Services LLC
• Magnolia Springs Counseling, LLC
• Jacob Mahan
• Sterling Mahan, H.A.S.

• Pulmonary Disease Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.