Individual provider Active NPI

Khalid B Mohammed, DO

  • Interventional Cardiology Physician
  • Riverview, FL
National Provider Identifier
1740701093
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
OS20816 Issued in FL
Practice address
13127 Vail Ridge Dr
Riverview, FL 33579-7196
Phone
(813) 661-6199
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5101023548 MI
Cardiovascular Disease Physician 207RC0000X OS20816 FL
Interventional Cardiology Physician 207RI0011X OS20816 FL Primary
Internal Medicine Physician 207R00000X 5101023548 MI

Addresses

Primary practice location

13127 Vail Ridge Dr
Riverview, FL 33579-7196

Mailing address

13127 Vail Ridge Dr
Riverview, FL 33579-7196
Phone (813) 661-6199

Other practice location 1

1425 Malabar Rd NE Ste 503
Palm Bay, FL 32907-2506
Phone (321) 434-8531

Other practice location 2

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

Other practice location 3

33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4000

Other practice location 4

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 295-5000

Other practice location 5

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-4486

Other identifiers 2

IdentifierTypeStateIssuer
XB407OtherFLHFMG
122618500MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607000815 FL Practitioner - Interventional Cardiology 0042581878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
South Shore Cardiovascular Associates IncGroup PAC ID 5092874909, 17 clinicians
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians
West Florida Cardiovascular Co-Management Associates, LLCGroup PAC ID 0547538316, 36 clinicians

Practice addresses (Care Compare)

13127 Vail Ridge Dr
Riverview, FL 33579-7196
Phone (813) 661-6199

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401

1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8121

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (800) 432-2301

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS20816FLMDCardiovascular Disease Physician
5101023548MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Cardiovascular Associates Inc Cardiovascular Disease CurrentSince Jul 20, 2024 Accepting new patients
West Florida Cardiovascular Co-Management Associates, LLC Cardiovascular Disease CurrentSince Jul 5, 2025 Accepting new patients

Locations

1159 Nikki View Dr
Brandon, FL 33511
Phone (813) 661-6199

425 S Kings Ave
Brandon, FL 33511
Phone (813) 661-6199

13127 Vail Ridge Dr
Riverview, FL 33579
Phone (813) 661-6199

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kmohammed779545@direct.hfhs.org
  • Direct secure messaging: kmohammed118451@mymichiganhealth.midirect.net

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.

Hospital & facility affiliations 7

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1740701093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13127 VAIL RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797196",
            "telephone_number": "813-661-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13127 VAIL RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797196",
            "telephone_number": "813-661-6199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Malabar Rd NE Ste 503",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329072506",
            "country_code": "US",
            "telephone_number": "321-434-8531",
            "fax_number": "321-434-8533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11800 E 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933472",
            "country_code": "US",
            "telephone_number": "586-573-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33155 Annapolis St",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "MI",
            "postal_code": "481842405",
            "country_code": "US",
            "telephone_number": "734-467-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-295-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6245 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481354001",
            "country_code": "US",
            "telephone_number": "734-458-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "KHALID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101023548",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "OS20816",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "OS20816",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101023548",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG",
            "identifier": "XB407",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122618500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.