Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mohammad Harisullah Khan, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1215598313

Mohammad Harisullah Khan, MD is an Internal Medicine in Orange Park, Florida. Qualified in 2019, 7 years ago. Practices with Carle Health Care Incorporated, a 1,543-clinician group and accepts Medicare assignment. Licensed in Florida and Illinois.

Years since qualifying
7
Licensed in
FL, IL
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2001 Kingsley Ave Gme Ofc
Orange Park, FL 32073
Phone: (904) 639-2009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036162469 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (FL)

Record details

NPI number1215598313
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2019
Last updated in NPPESApril 11, 2023
Certification dateApril 11, 2023
Mailing address2001 Kingsley Ave, Gme Office, Orange Park, FL 32073

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPICE/PALLIATIVE CARE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Carle Health Care Incorporated — 1543 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Other providers in Orange Park