Tareq Al-Khatib, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME0054121 Issued in FL

Practice address

2852 Tamiami TRL
Suite 5
Port Charlotte, FL 33952-5125

Phone

(941) 625-4442

Fax

(941) 625-9797

NPI assigned

Oct 2, 2007

Last updated

Nov 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tareq Al-Khatib

  • Surgery Physician
  • Port Charlotte, FL
  • NPI 1457434169
  NPD (past) Authorized official

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1972790020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL",
            "address_2": "SUITE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525125",
            "telephone_number": "941-625-4442",
            "fax_number": "941-625-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL",
            "address_2": "SUITE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525125",
            "telephone_number": "941-625-4442",
            "fax_number": "941-625-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-KHATIB",
        "first_name": "TAREQ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-054967",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0054121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049600600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meera Agarwal, M.D
• Martin Francisco Aguero, MD
• Noemi Aguila
• Rosalva Aguilar, LMHC
• Ajgs, Inc. (Comfort Keepers)
• Alan D. Shoopak D.M.D. ,P.a.
• Alan W Gruning DO & Associates PA
• Hassan Albassam, M.D.
• Fatin Shakir Albezargan, MD
• Alejandro Callejas MD

• Surgery Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.