Individual provider Active NPI

Marilynn Tedja, MD

  • Hospitalist Physician
  • Pearland, TX
National Provider Identifier
1013335108
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
R1307 Issued in TX
Practice address
16100 South Fwy
Pearland, TX 77584-1895
Phone
(713) 413-6587
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R1307 TX
Hospitalist Physician 208M00000X R1307 TX Primary

Addresses

Primary practice location

16100 South Fwy
Pearland, TX 77584-1895

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

6624 Fannin St Fl 19
Houston, TX 77030-2312
Phone (713) 442-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, GA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170724003307 CA Practitioner - Internal Medicine 7810267879 Reassigns benefits to 1 organization
I20180212001677 TX Practitioner - HospitalistPractitioner - Internal Medicine 7810267879 Reassigns benefits to 3 organizations
I20180607002151 GA Practitioner - Internal Medicine 7810267879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

6624 Fannin St
Houston, TX 77030-2312
Phone (713) 442-0000

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1307TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Bay Area Hospitalist Medical Group Inc Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Dec 9, 2017 Accepting new patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Aug 26, 2024 Accepting new patients

Locations

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

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

6624 Fannin St
Fl 19
Houston, TX 77030

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

6624 Fannin St
Houston, TX 77030
Phone (713) 442-1500

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

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: mtedja41802@icare.elcaminohospital.org
  • Direct secure messaging: mtedja85572@direct.kelsey-seybold.com
  • Direct secure messaging: mtedja560711@direct.llu.edu

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 1

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1013335108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SOUTH FWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775841895",
            "telephone_number": "713-413-6587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6624 Fannin St Fl 19",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302312",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDJA",
        "first_name": "MARILYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R1307",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R1307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.