DR. MATHEEN AHMED KHUDDUS (NPI# 1548330566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548330566 |
| Entity Type | Individual |
| Full Name | DR. MATHEEN AHMED KHUDDUS |
| Credential | M.D. |
| Practice Address |
4645 Nw 8th Ave Gainesville FL 32605-4524 |
| Practice Telephone | 3522642500 |
| Practice Fax Number | 3523319095 |
| Mailing Telephone | 3522642500 |
| Mailing Fax Number | 3523319095 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2017-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
ME88697 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
ME88697 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE RR | CM8550 | 01 |
| FL | 281192800 | 05 | |
| FL | BLUE CROSS FLORIDA | 25319 | 01 |
| Street Address |
4645 NW 8TH AVE |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32605-4524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023015617 | Aerica Lynette Savage | Nurse Practitioner | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2005-06-28 |
| 1558838904 | Kimberly Anne Lakin | Physician Assistant | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2018-10-24 |
| 1225546468 | Cearie Balkcom | Nurse Practitioner | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2018-01-22 |
| 1902250210 | Ann Lucke-wold | Nurse Practitioner | 4645 Nw 8th Ave, Gainesville, FL 32605 | 2016-04-22 |
| 1164809570 | Jessica Perry | Physician Assistant | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2015-05-05 |
| 1770822835 | Abigayil Megan Anderson | Nurse Practitioner | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2013-02-11 |
| 1275878001 | Genevieve Kerr Farnham | Nurse Practitioner | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2012-12-05 |
| 1790037208 | Alexander Michael Nackashi | Physician Assistant | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2012-10-08 |
| 1386909455 | Angela Rose Rivera | Physician Assistant | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2012-07-05 |
| 1164704086 | Ginger Crosby Riddle | Physician Assistant | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2011-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205435 | Remy Fadel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terr, Gainsville, FL 32605 | 2020-05-05 |
| 1518528652 | Family Restoration Station Counseling Center, LLC | Marriage & Family Therapist | 912 Nw 56th Terr, Suite A, Gainesville, FL 32605 | 2019-06-27 |
| 1568925105 | Ryeisha Hough | Behavior Technician | 1051 Sw 56 Terrace, Gainesville, FL 32605 | 2019-04-10 |
| 1003308040 | Titan Mri LLC | Clinic/Center | 919 Nw 57th St Ste 20, Gainesville, FL 32605 | 2018-06-05 |
| 1922598432 | Angela Maria Fernandez Manovel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terrace, Gainesville, FL 32605 | 2018-05-10 |
| 1396235800 | Aya Marachi | Student in an Organized Health Care Education/Training Program | 6500 W. Newberry Rd., Gainesville, FL 32605 | 2018-05-10 |
| 1053813543 | Jaime L Jasser | Counselor | 2240 Nw 40th Terrace Ste A, Gainesville, FL 32605 | 2018-03-01 |
| 1164932901 | Anesthesia Physician Solutions of North Florida, LLC | Anesthesiology | 6500 W Newberry Road, Gainesville, FL 32605 | 2017-10-06 |
| 1336667930 | Zina Theresse Durr | Adult Companion | 3124 Nw 29th Place, Gainesville, FL 32605 | 2017-09-03 |
| 1982126306 | Crystal Thompson Baumann | Nurse Practitioner | 6440 W Newberry Rd Ste 409, Gainesville, FL 32605 | 2017-07-07 |
| Find all providers in zip 32605 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154351781 | Howard Wayne Ramsey | Internal Medicine | 1151 Nw 64th Terrace, Interventional Cardiologists of Gainesville, Gainesville, FL 32605-4218 | 2006-07-03 |
| 1013972835 | Ellen Catherine Keeley | Internal Medicine | 1600 Sw Archer Rd Box 100277, Gainesville, FL 32610-0001 | 2006-04-18 |
| 1578839296 | Cardiovascular Clinic of North Georgia PC | Internal Medicine | 1287 Sims St, Gainesville, GA 30501-3851 | 2012-03-27 |
| 1093036089 | Falgun D Patel | Internal Medicine | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2010-06-14 |
| 1194952739 | Khaja Salahuddin Mohammed | Internal Medicine | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2009-06-22 |
| 1497902084 | Abhijit Ghatak | Internal Medicine | 1475 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501-3806 | 2008-08-26 |
| 1265484257 | Mark A Tulli | Internal Medicine | 4645 Nw 8th Ave, Gainesville, FL 32605-4524 | 2006-05-17 |
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| 1881212744 | North Broward Hospital District | Internal Medicine | 817 S University Dr Ste 104, Plantation, FL 33324-3345 | 2020-07-08 |
| 1821612821 | Satish Sivasankaran Md Pa | Internal Medicine | 5340 Gulf Dr Ste 101, New Port Richey, FL 34652-3922 | 2020-06-04 |
| 1699317933 | Abid A Shah Md LLC | Internal Medicine | 5741 Bee Ridge Rd Ste 420, Sarasota, FL 34233-5081 | 2019-10-08 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1205329620 | Central Florida Cardiovascular Imaging Center, LLC | Internal Medicine | 1717 Mayo Dr, Tavares, FL 32778-4307 | 2018-06-11 |
| 1568953511 | Orlando Lopez-fernandez Jr. | Internal Medicine | 2800 Ponce De Leon Blvd Ste 1480, Coral Gables, FL 33134-6921 | 2018-05-25 |
| 1467959668 | Cardiology Practice Pa | Internal Medicine | 5051 Ashington Landing Dr, Tampa, FL 33647-3515 | 2018-04-12 |
| 1619476785 | Synergy Health Group LLC | Internal Medicine | 7828 Collins Grove Rd, Jacksonville, FL 32256-7175 | 2018-02-05 |
| 1114425477 | Cardiac Cin of Miami LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760c, Miami, FL 33131-1815 | 2018-01-31 |
| Find all providers with the same taxonomy | ||||
| City | GAINESVILLE |
| Zip Code | 32605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.