Active NPI
George Khoudari, MD
- Gastroenterology Physician
- Port St Lucie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME168343
- Practice address
- 10050 SW Innovation Way
Port St Lucie, FL 34987-2117 - Phone
- (772) 223-5945
- Fax
- (772) 345-5365
- NPI assigned
- Jun 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35.131927 | OH | |
| Gastroenterology Physician | 207RG0100X | ME168343 | FL | Primary |
Addresses
Primary practice location
10050 SW Innovation Way
Port St Lucie, FL 34987-2117
Mailing address
10050 SW Innovation Way
Port St Lucie, FL 34987-2117
Phone (772) 223-5945
Other practice location 1
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-2855
Other practice location 2
9500 Euclid Ave
Cleveland, OH 44195-4122
Phone (216) 446-0346
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
- Gastroenterology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.26 of 100
- Quality
- 80.2
- Promoting interoperability
- 99.24
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 85 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 95 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Memorial Medical Center Inc | Current | Accepting new patients |
Locations
10050 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 344-3811
10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853
200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618
9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270
9500 Euclid Ave
#M8
Cleveland, OH 44195
6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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 and National Provider Directory roles.
-
dba Cleveland Clinic Martin North, South, Tradition Hospitals
- General Acute Care Hospital
- Stuart, FL
- NPI 1194790055
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Cleveland Clinic Indian River Hospital
- General Acute Care Hospital
- Vero Beach, FL
- NPI 1376512988
-
dba Cleveland Clinic Martin North, South, Tradition Hospitals
- General Acute Care Hospital
- Stuart, FL
- NPI 1194790055
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1578978995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10050 SW INNOVATION WAY",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349872117",
"telephone_number": "772-223-5945",
"fax_number": "772-345-5365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10050 SW INNOVATION WAY",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349872117",
"telephone_number": "772-223-5945",
"fax_number": "772-345-5365"
}
],
"practiceLocations": [
{
"address_1": "3800 Reservoir Rd NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200072113",
"country_code": "US",
"telephone_number": "202-444-2855",
"fax_number": "877-303-1462",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9500 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441954122",
"country_code": "US",
"telephone_number": "216-446-0346",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHOUDARI",
"first_name": "GEORGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-24",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.131927",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME168343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.