Individual provider Active NPI

Khalid Akbar Khan, MD

  • Internal Medicine Physician
  • Fort Eustis, VA
National Provider Identifier
1619955168
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101053819 Issued in VA
Practice address
576 Jefferson Ave
McDonald Army Comm Hospital Bldinternal Medicine Clinic
Fort Eustis, VA 23604
Phone
(757) 314-7722
Fax
(757) 314-7703
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101053819 VA Primary

Addresses

Primary practice location

576 Jefferson Ave
McDonald Army Comm Hospital Bldinternal Medicine Clinic
Fort Eustis, VA 23604

Mailing address

PO Box 9671
McDonald Army Comm Hospital Internal Medicine Clinic
Daytona Beach, FL 32120-9671
Phone (386) 676-7130

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
I20170309000690 FL Practitioner - Internal Medicine 4183679533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

937 N Spring Garden Rd
Deland, FL 32720-2560
Phone (386) 736-1948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053819VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Jan 16, 2017 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Jan 16, 2017 Accepting new patients
Gustavo Y. Vargas, M.D., Inc Past Accepting new patients

Locations

937 N Spring Garden Ave
Deland, FL 32720
Phone (386) 736-1948

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1619955168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "address_2": "MCDONALD ARMY COMM HOSPITAL INTERNAL MEDICINE CLINIC",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVE",
            "address_2": "MCDONALD ARMY COMM HOSPITAL BLDINTERNAL MEDICINE CLINIC",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "23604",
            "telephone_number": "757-314-7722",
            "fax_number": "757-314-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KHALID",
        "middle_name": "AKBAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101053819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eustis, VA

Sources for this page

Verify at the official NPI Registry.