Individual provider Active NPI

Khaja Moinuddeen, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Sugar Land, TX
National Provider Identifier
1154300903
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
N0286 Issued in TX
Practice address
4911 Sandhill Dr
Sugar Land, TX 77479-5320
Phone
(281) 238-7870
Fax
(281) 633-4985
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21707 WV
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X N0286 TX Primary

Addresses

Primary practice location

4911 Sandhill Dr
Sugar Land, TX 77479-5320

Mailing address

4911 Sandhill Dr
Sugar Land, TX 77479-5320
Phone (281) 238-7870

Other identifiers 2

IdentifierTypeStateIssuer
299860102MedicaidTX
3810001306MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KHAJA.MOINUDDEEN@hca9.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120420000050 TX Practitioner - Cardiac SurgeryPractitioner - General SurgeryPractitioner - Thoracic Surgery 9739142019 Reassigns benefits to 3 organizations
I20241030004026 ND Practitioner - Thoracic SurgeryPractitioner - Vascular SurgeryPractitioner - Cardiac Surgery 9739142019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: General Surgery, Thoracic Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Specialists of Clear Lake PLLCGroup PAC ID 6103904461, 10 clinicians
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

450 W Medical Ctr Blvd
600 Clear Lake Regional Medical Center
Webster, TX 77598-4233
Phone (281) 332-4596

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

Hospital & facility affiliations

  • HCA Houston Healthcare Southeast Hospital, Pasadena, TX, CCN 450097
  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakbend Medical Group CurrentSince Sep 17, 2012 Accepting new patients
Altru Health System CurrentSince Oct 24, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 11, 2024 Accepting new patients
Oakbend Medical Group CurrentSince Sep 17, 2012 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 11, 2024 Accepting new patients
Altru Health System CurrentSince Oct 24, 2024 Accepting new patients
Surgical Specialists of Clear Lake PLLC Surgery CurrentSince Jul 1, 2019 Accepting new patients
Altru Health System Surgery Current Accepting new patients
Camden-Clark Physician Corporation Surgery PastSince Aug 1, 2014 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients
Southern Texas Physicians Network Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Khaja Moinuddeen,MD,PA Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Sep 15, 2012 Accepting new patients

Locations

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3801 Vista Rd
Ste 300
Pasadena, TX 77504
Phone (713) 359-2221

3801 Vista Rd
Ste 360
Pasadena, TX 77504
Phone (713) 359-2221

4000 Spencer Hwy
Pasadena, TX 77504
Phone (713) 359-1000

4911 Sandhill Dr
Sugar Land, TX 77479
Phone (281) 238-7870

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

450 W Medical Center Blvd
Ste 600
Webster, TX 77598
Phone (281) 338-3270

Interoperability endpoints

  • Direct secure messaging: kmoinuddeen432609@christushealth.direct-ci.net
  • Direct secure messaging: kmoinuddeen26726@directhoustonmethodist.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1154300903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 SANDHILL DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795320",
            "telephone_number": "281-238-7870",
            "fax_number": "281-633-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 SANDHILL DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795320",
            "telephone_number": "281-238-7870",
            "fax_number": "281-633-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOINUDDEEN",
        "first_name": "KHAJA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21707",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "N0286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299860102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001306",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KHAJA.MOINUDDEEN@hca9.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4911 Sandhill Dr",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774795320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.