Individual provider Active NPI

Khawaja Azimuddin, M.D.

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1811946478
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M1012 Issued in TX
Practice address
1125 Cypress Station Dr
Suite G3
Houston, TX 77090-3054
Phone
(281) 583-1300
Fax
(281) 583-1303
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M1012 TX Primary

Addresses

Primary practice location

1125 Cypress Station Dr
Suite G3
Houston, TX 77090-3054

Mailing address

1125 Cypress Station Dr
Suite G3
Houston, TX 77090-3054
Phone (281) 583-1300

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
I20050910000263 TX Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 1951333947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Colon and Rectal Surgery, P.a.Group PAC ID 0042242034, 3 clinicians

Practice addresses (Care Compare)

1125 Cypress Station Dr
Suite G 3
Houston, TX 77090-3055
Phone (281) 583-1300

Hospital & facility affiliations

  • Houston Methodist Willowbrook Hospital Hospital, Houston, TX, CCN 450844
  • St Luke'S Hospital at the Vintage Hospital, Houston, TX, CCN 670075
  • HCA Houston Healthcare Northwest Hospital, Houston, TX, CCN 450638

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy83
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1012TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Colon & Rectal Surgery, P.a. CurrentSince May 16, 2005 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

800 Peakwood Dr
Ste 4C
Houston, TX 77090
Phone (281) 444-3181

1125 Cypress Station Dr
Ste G-3
Houston, TX 77090
Phone (281) 540-8779

17189 Interstate 45 S
Ste 275
Shenandoah, TX 77385
Phone (281) 362-1368

920 Medical Plaza Dr
Ste 550
Shenandoah, TX 77380
Phone (281) 440-0101

Interoperability endpoints

  • Direct secure messaging: khawaja.azimuddin@gcrs.eclinicaldirectplus.com

Organizations & group practices 2

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1811946478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CYPRESS STATION DR",
            "address_2": "SUITE G3",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903054",
            "telephone_number": "281-583-1300",
            "fax_number": "281-583-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CYPRESS STATION DR",
            "address_2": "SUITE G3",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903054",
            "telephone_number": "281-583-1300",
            "fax_number": "281-583-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIMUDDIN",
        "first_name": "KHAWAJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M1012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.