Individual provider Active NPI

Adil Arshad Khan, MD

  • Vascular Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1417210717
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME141817 Issued in FL
Practice address
3627 University Blvd S Ste 135
Jacksonville, FL 32216-4231
Phone
(904) 398-8147
Fax
(904) 400-6674
NPI assigned
Jun 21, 2012
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME141817 FL Primary

Addresses

Primary practice location

3627 University Blvd S Ste 135
Jacksonville, FL 32216-4231

Mailing address

1824 King St
Suite 200
Jacksonville, FL 32204
Phone (904) 384-3343

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adilkhan@cvsapa.allscriptsdirect.net Direct

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
I20191219002075 FL Practitioner - Vascular Surgery 8921300344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)37
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141817FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic & Vascular Surgical Associates PA Vascular Surgery CurrentSince Oct 7, 2019 Accepting new patients

Locations

14540 Old St Augustine Rd
Ste 2593
Jacksonville, FL 32258
Phone (904) 328-5289

1824 King St
Ste 200
Jacksonville, FL 32204
Phone (904) 384-3343

3599 University Blvd S
Ste 602
Jacksonville, FL 32216
Phone (904) 398-8147

3627 University Blvd S
Ste 135
Jacksonville, FL 32216
Phone (904) 398-8147

6820 Southpoint Pkwy
Ste 1
Jacksonville, FL 32216
Phone (904) 289-9600

8767 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (704) 542-2256

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: adilkhan@cvsapa.allscriptsdirect.net

Organizations & group practices 1

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 6

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1417210717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-384-3343",
            "fax_number": "904-400-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 135",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164231",
            "telephone_number": "904-398-8147",
            "fax_number": "904-400-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ADIL",
        "middle_name": "ARSHAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME141817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adilkhan@cvsapa.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3627 University Blvd S Ste 135",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322164231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.