Individual provider Active NPI

Damodharan Vaidyanathan, M.D

  • Hospitalist Physician
  • Houston, TX
National Provider Identifier
1376753087
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
N3364 Issued in TX
Practice address
11800 Astoria Blvd
Houston, TX 77089-6041
Phone
(508) 847-0045
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202139 LA
Hospitalist Physician 208M00000X N3364 TX Primary
Internal Medicine Physician 207R00000X N3364 TX

Addresses

Primary practice location

11800 Astoria Blvd
Houston, TX 77089-6041

Mailing address

4703 Stratford LN
Sugar Land, TX 77479-4561
Phone (508) 847-0045

Other practice location 1

4703 Stratford Lane
Sugar Land, TX 77479
Phone (508) 847-0045

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
I20100802000849 TX Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Emergency Medicine 7719040278 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Emergency Medicine, Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

11800 Astoria Blvd
Houston, TX 77089-6041
Phone (281) 929-6259

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202139LAMDInternal Medicine Physician
N3364TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Memorial Hermann Medical Group Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Gulf Coast Physician Services, PLLC Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Jefferson Physician Services, PLLC Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Texas Em-I Medical Services, PA Internal Medicine Past Accepting new patients
Memorial Hermann Health System Past Accepting new patients
Hni Medical Services Internal Medicine Past Accepting new patients
Wharton Physician Services PA Hospitalist Past Accepting new patients

Locations

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273

921 Gessner Rd
Rm 317
Houston, TX 77024
Phone (713) 242-3768

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

9250 Pinecroft Dr
Ste N2101
Shenandoah, TX 77380
Phone (713) 897-2307

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

Organizations & group practices 10

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 6

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1376753087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4703 STRATFORD LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794561",
            "telephone_number": "508-847-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ASTORIA BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896041",
            "telephone_number": "508-847-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4703 Stratford Lane",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "77479",
            "country_code": "US",
            "telephone_number": "508-847-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIDYANATHAN",
        "first_name": "DAMODHARAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "202139",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "N3364",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N3364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.