Organization Active NPI

Vascular Clinic PLLC

  • Vascular Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1922896240
Registry record updated Jan 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR CLINIC PLLC
Practice address
775 Primera Blvd Ste 1031
Lake Mary, FL 32746-2190
Phone
(561) 957-7555
NPI assigned
Apr 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2026

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

Authorized official

Name
Dr. Khalil Masabni, MDNPI 1497173017
Title
Medical Director
Phone
(561) 957-7555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

775 Primera Blvd Ste 1031
Lake Mary, FL 32746-2190

Mailing address

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

Other practice location 1

960 Rinehart Rd Ste 2060
Lake Mary, FL 32746-1563
Phone (407) 603-0060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250508003344 FL Part B Supplier - Clinic/Group Practice 4284151697 Receives reassigned benefits from 1 practitioner
Practice locations: Debary, FL; Lake Mary, FL

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767484800000",
    "number": "1922896240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PRIMERA BLVD STE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462190",
            "telephone_number": "561-957-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PRIMERA BLVD STE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462190",
            "telephone_number": "561-957-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 Rinehart Rd Ste 2060",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327461563",
            "country_code": "US",
            "telephone_number": "407-603-0060",
            "fax_number": "888-355-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VASCULAR CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2026-01-04",
        "certification_date": "2026-01-04",
        "status": "A",
        "authorized_official_last_name": "MASABNI",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "561-957-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.