Active NPI
Anna Rose Maldonado, M.D
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1053438879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 41108
- Practice address
- 1613 Kentucky Ave
San Antonio, TX 78201-5822 - Phone
- (210) 573-4031
- NPI assigned
- Mar 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 41108 | WA | Primary |
Addresses
Primary practice location
1613 Kentucky Ave
San Antonio, TX 78201-5822
Mailing address
1613 Kentucky Ave
San Antonio, TX 78201-5822
Phone (210) 573-4031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41108 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marillac Community Health Centers | Past | Accepting new patients | |
| Marillac Community Health Centers | Past | Accepting new patients | |
| Marillac Community Health Centers | Past | Accepting new patients | |
| Marillac Community Health Centers | Past | Accepting new patients | |
| Marillac Community Health Centers | Past | Accepting new patients | |
| Marillac Community Health Centers | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1073120614
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1093249518
-
- Federally Qualified Health Center (FQHC)
- Metairie, LA
- NPI 1629329735
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1730632795
-
- Federally Qualified Health Center (FQHC)
- New Orleans, LA
- NPI 1780935973
-
- Clinic/Center
- Kenner, LA
- NPI 1831594241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053438879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 KENTUCKY AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782015822",
"telephone_number": "210-573-4031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 KENTUCKY AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782015822",
"telephone_number": "210-573-4031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "ANNA",
"middle_name": "ROSE",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "41108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.