Individual provider Active NPI

Azamuddin Khaja, M.D.

  • Interventional Cardiology Physician
  • Farmington, MO
National Provider Identifier
1699723486
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2005024106 Issued in MO
Practice address
1151 Hazel LN
Farmington, MO 63640-1920
Phone
(573) 705-7870
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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.

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LC 526 clinicians

Practice addresses (Care Compare)

1101 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751

1103 W Liberty St
Farmington, MO 63640-1921
Phone (573) 756-6751

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1439 US Hwy 61
Suite a
Festus, MO 63028-4154
Phone (636) 543-7720

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

513 W Pine St
Farmington, MO 63640-1439
Phone (573) 705-7870

Hospital & facility affiliations

  • Parkland Health Center Hospital, Farmington, MO, CCN 260163
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Ste Genevieve County Memorial Hospital Hospital, Sainte Genevieve, MO, CCN 261330
  • Parkland Health Center - Bonne Terre Hospital, Bonne Terre, MO, CCN 260779
  • Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting21
Pacemaker insertion or repair26
Varicose vein removal1-10
Leg revascularization (restoring blood flow)23

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20061019000315 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Emergency Medicine 7618973322 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-095412OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Dec 1, 2023 Accepting new patients
Mid-America Heart and Vascular, LLC Cardiovascular Disease Current Accepting new patients
Physician Groups LC Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Moberly HBP Medical Group LLC Past Accepting new patients
Midwest Heart and Vein Center, LLC Cardiovascular Disease Past Accepting new patients

Locations

1439 US Highway 61
Ste A
Crystal Cty, MO 63028
Phone (636) 931-7101

1151 Hazel Ln
Farmington, MO 63640
Phone (573) 705-7870

513 W Pine St
Farmington, MO 63640
Phone (573) 701-0090

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

Interoperability endpoints

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

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35-095412 OH
Cardiovascular Disease Physician 207RC0000X 2005024106 MO
Internal Medicine Physician 207R00000X 2005024106 MO
Interventional Cardiology Physician 207RI0011X 2005024106 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1151 Hazel LN
Farmington, MO 63640-1920

Mailing address

1151 Hazel LN
Farmington, MO 63640-1920
Phone (573) 705-7870

Other practice location 1

1439 US Highway 61 Ste A
Festus, MO 63028-4154
Phone (636) 931-7101

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
024106OtherMOMEDICAL LICENSE

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 3, 2025.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1699723486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 HAZEL LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401920",
            "telephone_number": "573-705-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HAZEL LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401920",
            "telephone_number": "573-705-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1439 US Highway 61 Ste A",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284154",
            "country_code": "US",
            "telephone_number": "636-931-7101",
            "fax_number": "636-933-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAJA",
        "first_name": "AZAMUDDIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-095412",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2005024106",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005024106",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2005024106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "024106",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "513 W Pine St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636401439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.