Individual provider Active NPI

Ibrahim Khansa, MD

  • Plastic and Reconstructive Surgery Physician
  • Austin, TX
National Provider Identifier
1649567769
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
U6996 Issued in TX
Practice address
3305 Northland Dr Ste 210
Austin, TX 78731-4988
Phone
(512) 615-6566
Fax
(281) 962-8002
NPI assigned
Jul 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X U6996 TX Primary

Addresses

Primary practice location

3305 Northland Dr Ste 210
Austin, TX 78731-4988

Mailing address

3305 Northland Dr Ste 210
Austin, TX 78731-4988
Phone (512) 615-6566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170720001197 CA Practitioner - Plastic and Reconstructive Surgery 2163666074 Reassigns benefits to 1 organization
I20231011004065 TX Practitioner - Plastic and Reconstructive Surgery 2163666074 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U6996TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Khansa Plastic Surgery PLLC Plastic Surgery CurrentSince Nov 26, 2025 Accepting new patients
Texas Children's Physician Group CurrentSince Jun 15, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

3305 Northland Dr
Ste 210
Austin, TX 78731
Phone (512) 454-5716

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: ikhansa483644@prddirect.texaschildrens.org

Organizations & group practices 4

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": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1649567769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 NORTHLAND DR STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314988",
            "telephone_number": "512-615-6566",
            "fax_number": "281-962-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 NORTHLAND DR STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314988",
            "telephone_number": "512-615-6566",
            "fax_number": "281-962-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANSA",
        "first_name": "IBRAHIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-10",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "U6996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.