Individual provider Active NPI

Jibran Navaid Khan, D.O

  • Emergency Medicine Physician
  • Apopka, FL
National Provider Identifier
1962864181
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS16055 Issued in FL
Practice address
2100 Ocoee Apopka Rd
Apopka, FL 32703-9210
Phone
(407) 599-2700
NPI assigned
Mar 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS16055 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

Mailing address

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210
Phone (407) 599-2700

Other practice location 1

17 Davis Blvd
Suite 308
Tampa, FL 33606-3475
Phone (813) 250-2506

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
I20190708001159 FL Practitioner - Emergency Medicine 0648505032 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16055FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Oct 15, 2020 Accepting new patients
Emergency Physicians of Pinellas PA Emergency Medicine CurrentSince May 19, 2019 Accepting new patients
Em Alliance LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Emergency Physicians of St Petersburg PA Emergency Medicine CurrentSince May 19, 2019 Accepting new patients
Emergency Physicians of Crossroads Emergency Medicine PastSince May 7, 2023 Accepting new patients

Locations

2100 Ocoee Apopka Rd
Apopka, FL 32703
Phone (407) 607-7000

5506 14th St W
Bradenton, FL 34207
Phone (941) 745-7372

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

633 75th St W
Palma Sola, FL 34209
Phone (941) 745-7311

3070 Grand Ave
Pinellas Park, FL 33782
Phone (727) 553-7300

603 7th St S
Ste 360
St Petersburg, FL 33701
Phone (727) 553-7300

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

16504 US 301 S
Wimauma, FL 33598
Phone (813) 642-1000

7 Easton Oval
#L4387
Columbus, OH 43219

Organizations & group practices 5

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": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1962864181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 OCOEE APOPKA RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327039210",
            "telephone_number": "407-599-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 OCOEE APOPKA RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327039210",
            "telephone_number": "407-599-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Davis Blvd",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063475",
            "country_code": "US",
            "telephone_number": "813-250-2506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JIBRAN",
        "middle_name": "NAVAID",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS16055",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.