NPIMap

Individual provider Active NPI

Jihad M Khalil, M.D.

  • Cardiovascular Disease Physician
  • Fort Myers, FL
National Provider Identifier
1396740478
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME113881 Issued in FL
Practice address
15244 Fiddlesticks Blvd
Fort Myers, FL 33912-2439
Phone
(239) 000-0000
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4777 SD
Cardiovascular Disease Physician 207RC0000X ME113881 FL Primary

Addresses

Primary practice location

15244 Fiddlesticks Blvd
Fort Myers, FL 33912-2439

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130304000371 FL Practitioner - Cardiovascular Disease (Cardiology) 1951329101 Reassigns benefits to 1 organization
I20190523002278 OH Practitioner - Cardiovascular Disease (Cardiology) 1951329101 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 721-5117

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4777SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Medical Services Company LLC CurrentSince Sep 1, 2020 Accepting new patients
Clinic Medical Services Company CurrentSince Sep 1, 2020 Accepting new patients
Shahla Medical Group, PA CurrentSince Jan 13, 2013 Accepting new patients
The Cleveland Clinic Foundation CurrentSince May 8, 2019 Accepting new patients
Wooster Clinic, LLC CurrentSince Jan 12, 2025 Accepting new patients
Sioux Valley Heart Partners Past Accepting new patients
LCM Pathologists PC Past Accepting new patients

Locations

8800 Terrene Ct
Ste 102
Bonita Springs, FL 34135
Phone (239) 948-3444

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFIAAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1396740478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15244 FIDDLESTICKS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339122439",
            "telephone_number": "239-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "JIHAD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SD",
            "license": "4777",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME113881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.