Individual provider Active NPI

Mohammed Mominul Haque, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1689604100
Registry record updated Dec 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000160353 Issued in MO
Practice address
4455 Duncan Ave
Saint Louis, MO 63110-1111
Phone
(314) 658-3800
Fax
(636) 333-4510
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2000160353 MO Primary

Addresses

Primary practice location

4455 Duncan Ave
Saint Louis, MO 63110-1111

Mailing address

PO Box 1449
Maryland Heights, MO 63043-0449
Phone (314) 713-3665

Other identifiers 1

IdentifierTypeStateIssuer
205437833MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, VA, OK, TX, MD5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20031113000653 MO Practitioner - HospitalistPractitioner - Internal Medicine 6608780747 Reassigns benefits to 4 organizations
I20250716003065 VA Practitioner - Internal Medicine 6608780747 Reassigns benefits to 1 organization
I20250902001655 OK Practitioner - Internal Medicine 6608780747 Reassigns benefits to 1 organization
I20251028000953 TX Practitioner - Internal Medicine 6608780747 Reassigns benefits to 1 organization
I20260218000060 MD Practitioner - Internal Medicine 6608780747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Observation Medicine Services of Oklahoma, LLCGroup PAC ID 9931562956, 203 clinicians

Practice addresses (Care Compare)

15225 Heathcote Blvd
Haymarket, VA 20169-6264
Phone (240) 686-2300

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-3131

8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone (240) 686-2300

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 369-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Texas, PLLC Internal Medicine CurrentSince Aug 17, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince May 2, 2025 Accepting new patients
Gateway Hospitalist PC Internal Medicine CurrentSince Jul 15, 2004 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine Current Accepting new patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Jul 15, 2025 Accepting new patients
Theoria Medical Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Emergency Medicine Associates PA PC Internal Medicine CurrentSince Feb 5, 2026 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Sep 1, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 2, 2025 Accepting new patients
Bi-State Cardiovascular Consultant PC CurrentSince Jan 25, 2011 Accepting new patients
Mercy Hospital South Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Manchester Operator LLC Past Accepting new patients
Emerald Heights LLC Past Accepting new patients
Alliance Inpatient Medicine Inc Past Accepting new patients
The Woodlands of Maryland Heights LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

800 Chambers Rd
Ferguson, MO 63135
Phone (314) 522-8100

9191 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 491-6190

312 Solley Dr
Manchester, MO 63021
Phone (636) 391-0666

3201 Parkwood Ln
Maryland Hts, MO 63043
Phone (314) 291-5911

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

10018 Kennerly Rd
Fl 3
Saint Louis, MO 63128
Phone (314) 361-8100

2705 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 394-3319

2705 Dougherty Ferry Rd
Ste 201
Saint Louis, MO 63122
Phone (314) 821-5461

5408 S Broadway
Saint Louis, MO 63111
Phone (314) 353-7225

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFDECD

Organizations & group practices 17

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 17

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1689604100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630430449",
            "telephone_number": "314-713-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 DUNCAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101111",
            "telephone_number": "314-658-3800",
            "fax_number": "636-333-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "MOHAMMED",
        "middle_name": "MOMINUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000160353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205437833",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.