Khaled Ibrahim, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN1088 Issued in FL

Practice address

264A Palm Coast Pkwy NE
Palm Coast, FL 32137-8217

Phone

(386) 446-5505

NPI assigned

Jul 15, 2016

Last updated

Jul 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 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

Specialty

General Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Alina Community Center at Mount Dora LLC

  • Family Medicine Physician
  • Mount Dora, FL
  • NPI 1811550346
  Medicare reassignment NPD
• Roy H Hinman MD PA

  dba Island Doctors

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1649383845
  Medicare reassignment NPD
• Conviva Medical Center Management LLC

  dba Conviva Care Center

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment
• Alina Community Center at Mount Dora LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Dora, FL
  • NPI 1841801842
  NPD
• Island Doctors Intrastate LLC

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1568083889
  NPD
• Lina L Feaster PA

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1922205251
  NPD (past)

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

• Memorial Hospital Flagler Inc

  dba AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1497108393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ARRICOLA AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320804515",
            "telephone_number": "904-825-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264A PALM COAST PKWY NE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378217",
            "telephone_number": "386-446-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3691 Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321292317",
            "country_code": "US",
            "telephone_number": "386-368-8876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "KHALED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1088",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19420",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaled.ibrahim.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3691 Clyde Morris Blvd",
            "city": "Port Orange",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321292317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.