Individual provider Active NPI

Mohammed Musa Khan, M.D.

  • Cardiovascular Disease Physician
  • Lufkin, TX
National Provider Identifier
1265418404
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
K3772 Issued in TX
Practice address
310 Gaslight Blvd
Lufkin, TX 75904-3133
Phone
(936) 632-8787
Fax
(936) 632-8832
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X K3772 TX
Cardiovascular Disease Physician 207RC0000X K3772 TX Primary

Addresses

Primary practice location

310 Gaslight Blvd
Lufkin, TX 75904-3133

Mailing address

310 Gaslight Blvd
Lufkin, TX 75904-3133
Phone (936) 632-8787

Other practice location 1

209 Gaslight Blvd
Lufkin, TX 75904-3134
Phone (936) 632-8787

Other practice location 2

505 S John Redditt Dr
Lufkin, TX 75904-3120
Phone (936) 632-8787

Other practice location 3

1105 W Frank Ave
Lufkin, TX 75904-3303
Phone (936) 632-8787

Other identifiers 1

IdentifierTypeStateIssuer
041134001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070630000083 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 6406954627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor St. Luke'S Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

310 Gaslight Blvd
Lufkin, TX 75904-3133
Phone (936) 632-8787

Hospital & facility affiliations

  • CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
  • Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
  • Houston Methodist Hospital Hospital, Houston, TX, CCN 450358

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting22
Pacemaker insertion or repair1-10
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
Baylor St. Luke'S Medical Group Cardiovascular Disease CurrentSince Nov 1, 2017 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

310 Gaslight Blvd
Lufkin, TX 75904

209 Gaslight Blvd
Lufkin, TX 75904

505 S John Redditt Dr
Lufkin, TX 75904
Phone (713) 512-1200

600 E Hospital St
San Augustine, TX 75972
Phone (936) 275-4420

17198 St Lukes Way
Ste 440
The Woodlands, TX 77384
Phone (936) 266-2500

17350 St Lukes Way
Ste 400
The Woodlands, TX 77384
Phone (832) 249-3721

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
  • Direct secure messaging: m.khan@direct.hiet.nextgenshare.com

Organizations & group practices 1

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.

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1265418404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Gaslight Blvd",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043134",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 S John Redditt Dr",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043120",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 W Frank Ave",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043303",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMED",
        "middle_name": "MUSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "K3772",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K3772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041134001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.