Khadidja Koraibaa, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

ME111327 Issued in FL

Practice address

951 N Washington Ave
Parrish Medical Group. Hospitalist Dept
Titusville, FL 32796-2163

Phone

(321) 268-6111

Fax

(321) 268-6360

NPI assigned

Aug 30, 2006

Last updated

Jun 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1124252333
  Medicare reassignment NPD
• Sound Physicians of Florida IV, LLC

  • Internal Medicine Physician
  • Palm Coast, FL
  • NPI 1740633635
  Medicare reassignment NPD
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1861150625
  NPD
• Sound Physicians of Florida IV, LLC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1235712415
  NPD
• Wentworth Douglass Physician Corporation

  • Diagnostic Radiology Physician
  • Somersworth, NH
  • NPI 1295326494
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1356451041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CENTURY MEDICAL DR",
            "address_2": "SUITE C",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962100",
            "telephone_number": "321-268-6264",
            "fax_number": "321-268-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "address_2": "PARRISH MEDICAL GROUP. HOSPITALIST DEPT",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-268-6111",
            "fax_number": "321-268-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORAIBAA",
        "first_name": "KHADIDJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME111327",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME111327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004451000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda M Kodesch, M.D.
• Sarah Elizabeth Koehnemann, O.D
• Jennifer Eleanor Koffman, COTA/L
• Soteria Kontis, HEALTH COACH
• Leslie Kontogiannis
• Nikolaos Koukos, ARNP-FNP
• Brooke Erin Kovinsky, DDS
• Lillian Katherine Krick
• Joanielee Kriz, D.C.
• Richard Krubel, MD

• Hospitalist Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.