Active NPI
Khushi Acushla Dhaliwal, M.D.
- Family Medicine Physician
- Wimauma, FL
National Provider Identifier
1396988952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME113583
- Practice address
- 5113 Sr 674, Ste 103
Wimauma, FL 33598 - Phone
- (813) 633-2000
- Fax
- (813) 849-9301
- NPI assigned
- Apr 13, 2009
- Last updated
- Jun 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME113583 | FL | Primary |
Addresses
Primary practice location
5113 Sr 674, Ste 103
Wimauma, FL 33598
Mailing address
5113, Sr 674,Ste 103
Wimauma, FL 33598
Phone (813) 633-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006450100 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5113 Sr
674 Suite 103
Wimauma, FL 33598-3515
Phone (813) 633-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME113583 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Bay Family Physicians Inc | Family Medicine | Current | Accepting new patients |
| Florida Medical Associates LLC | Past | Accepting new patients |
Locations
4874 Sun City Center Blvd
Sun City Center, FL 33573
Phone (813) 419-1220
5113 State Road 674
Ste 103
Wimauma, FL 33598
Phone (813) 633-2000
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIBBCA
- https://fhir4.healow.com/fhir/r4/BIBBCA/Endpoint/BIBBCA
- khushi.dhaliwal@tbfp.eclinicaldirectplus.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sunstate Doctors Medical Group
- Primary Care Clinic/Center
- Wimauma, FL
- NPI 1396000154
Family Medicine
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Bradenton, FL
- NPI 1295728186
-
- Home Health Agency
- Lakeland, FL
- NPI 1952309171
-
dba Bon Secours Home Care by Compassus
- Home Health Agency
- Sun City Center, FL
- NPI 1003634924
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
-
- Home Health Agency
- Brandon, FL
- NPI 1437663465
-
dba St. Joseph's Women's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
-
dba HCA Florida South Shore Hospital
- General Acute Care Hospital
- Sun City Center, FL
- NPI 1164476867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1396988952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5113, SR 674,STE 103",
"city": "WIMAUMA",
"state": "FL",
"postal_code": "33598",
"telephone_number": "813-633-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5113 SR 674, STE 103",
"city": "WIMAUMA",
"state": "FL",
"postal_code": "33598",
"telephone_number": "813-633-2000",
"fax_number": "813-849-9301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHALIWAL",
"first_name": "KHUSHI",
"middle_name": "ACUSHLA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-13",
"last_updated": "2023-06-16",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME113583",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006450100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wimauma, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.