Individual provider Active NPI

Vikesh Khanijow, M.D.

  • Gastroenterology Physician
  • Palm Harbor, FL
National Provider Identifier
1962768531
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME136688 Issued in FL
Practice address
33920 US 19 N Ste 124
Palm Harbor, FL 34684
Phone
(727) 785-7654
Fax
(727) 787-0061
NPI assigned
Apr 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME136688 FL Primary

Addresses

Primary practice location

33920 US 19 N Ste 124
Palm Harbor, FL 34684

Mailing address

3001 Executive Dr Ste 130
Clearwater, FL 33762-5323
Phone (727) 349-0005

Other practice location 1

2044 Trinity Oaks Blvd Ste 120
Trinity, FL 34655-4405
Phone (727) 372-1001

Other practice location 2

12780 Race Track Rd Ste 405
Tampa, FL 33626-1395
Phone (813) 854-2531

Other identifiers 1

IdentifierTypeStateIssuer
025156200MedicaidFL

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
I20180906003061 FL Practitioner - Gastroenterology 2365607249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Central Gastroenterology LLPGroup PAC ID 0648322362, 82 clinicians

Practice addresses (Care Compare)

33920 US Hwy 19 N
Suite 124
Palm Harbor, FL 34684-2619
Phone (727) 785-7654

Hospital & facility affiliations

  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Dunedin Hospital Hospital, Dunedin, FL, CCN 100043
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy86
Upper gastrointestinal (GI) endoscopy for acid reflux119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Gastroenterology LLP Gastroenterology CurrentSince Sep 4, 2018 Accepting new patients
Virtua Medical Group, PA Internal Medicine Past Accepting new patients
Daly Klibanoff Peebles & Zeitlin MD PA PastSince Sep 4, 2018 Accepting new patients
Gastro Florida Pharmacy, LLC PastSince Dec 15, 2019 Accepting new patients

Locations

3001 Executive Dr
Ste 130
Clearwater, FL 33762
Phone (727) 329-3371

33920 US Highway 19 N
Ste 124
Palm Harbor, FL 34684
Phone (727) 785-7654

6225 66th St N
Pinellas Park, FL 33781
Phone (727) 521-0994

1840 Mease Dr
Ste 305
Safety Harbor, FL 34695
Phone (727) 669-5849

12780 Race Track Rd
Ste 405
Tampa, FL 33626
Phone (813) 854-2531

2044 Trinity Oaks Blvd
Ste 120
Trinity, FL 34655
Phone (727) 372-1001

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

Hospital & facility affiliations 5

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": "1333843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1962768531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXECUTIVE DR STE 130",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337625323",
            "telephone_number": "727-349-0005",
            "fax_number": "727-541-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33920 US 19 N STE 124",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-785-7654",
            "fax_number": "727-787-0061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2044 Trinity Oaks Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Trinity",
            "state": "FL",
            "postal_code": "346554405",
            "country_code": "US",
            "telephone_number": "727-372-1001",
            "fax_number": "727-787-0061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12780 Race Track Rd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336261395",
            "country_code": "US",
            "telephone_number": "813-854-2531",
            "fax_number": "727-787-0061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHANIJOW",
        "first_name": "VIKESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-08",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME136688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025156200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.