Individual provider Active NPI

Khalil Masabni, M.D.

  • Vascular Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1497173017
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME157128 Issued in FL
Practice address
960 Rinehart Rd Ste 2060
Lake Mary, FL 32746-1563
Phone
(407) 225-5557
Fax
(888) 355-7757
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X EMC0003827 MI
Vascular Surgery Physician 2086S0129X 2024029893 MO
Vascular Surgery Physician 2086S0129X ME157128 FL Primary

Addresses

Primary practice location

960 Rinehart Rd Ste 2060
Lake Mary, FL 32746-1563

Mailing address

960 Rinehart Rd Ste 2060
Lake Mary, FL 32746-1563
Phone (561) 957-7555

Other practice location 1

802 N Riverside Rd Ste 200
Saint Joseph, MO 64507-2553
Phone (816) 271-6666

Other practice location 2

5250 Auto Club Dr Ste 300
Dearborn, MI 48126-2619
Phone (520) 559-3888

Other identifiers 1

IdentifierTypeStateIssuer
200145538MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240827003899 MO Practitioner - Vascular Surgery 3476778325 Reassigns benefits to 3 organizations
I20241116000419 FL Practitioner - Vascular Surgery 3476778325 Reassigns benefits to 2 organizations
I20250424003194 MI Practitioner - Vascular Surgery 3476778325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5202 Faraon St
Suite a
Saint Joseph, MO 64506-3840
Phone (816) 271-1067

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-3500

775 Primera Blvd
Suite 1031
Lake Mary, FL 32746-2190
Phone (561) 957-7555

901 Heartland Rd
Saint Joseph, MO 64506-6201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EMC0003827MIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 27, 2024 Accepting new patients
Vascular Clinic PLLC Vascular Surgery CurrentSince May 2, 2025 Accepting new patients
Michigan Vascular Surgery PLLC Vascular Surgery CurrentSince Mar 25, 2025 Accepting new patients
Heartland Regional Medical Center Surgery CurrentSince May 28, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 19, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 19, 2024 Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Oct 27, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 19, 2024 Accepting new patients
Heartland Regional Medical Center CurrentSince May 28, 2025 Accepting new patients
Heartland Regional Medical Center Current Accepting new patients
Macon Cardiovascular Institute Surgery PastSince Jun 1, 2021 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

410 Celebration Pl
Ste 402
Kissimmee, FL 34747
Phone (407) 296-1871

960 Rinehart Rd
Ste 2060
Lake Mary, FL 32746
Phone (407) 499-2826

775 Primera Blvd
Ste 1031
Lake Mary, FL 32746
Phone (407) 333-9766

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

5250 Auto Club Dr
Ste 300
Dearborn, MI 48126
Phone (313) 724-9000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

802 N Riverside Rd
Ste 200
Saint Joseph, MO 64507
Phone (816) 271-6666

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFHIDD/Endpoint/JFHIDD
  • Direct secure messaging: khalil.masabni.1@2697.direct.athenahealth.com
  • Direct secure messaging: drkhalilmasabni@vascular4ed.kareodirect.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1497173017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 RINEHART RD STE 2060",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461563",
            "telephone_number": "561-957-7555",
            "fax_number": "888-355-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 RINEHART RD STE 2060",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461563",
            "telephone_number": "407-225-5557",
            "fax_number": "888-355-7757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 N Riverside Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645072553",
            "country_code": "US",
            "telephone_number": "816-271-6666",
            "fax_number": "816-271-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5250 Auto Club Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262619",
            "country_code": "US",
            "telephone_number": "520-559-3888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASABNI",
        "first_name": "KHALIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "EMC0003827",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2024029893",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME157128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200145538",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.