Organization Active NPI

Magnificat Primary Care LLC

  • Family Medicine Physician
  • Spring, TX
National Provider Identifier
1063950459
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAGNIFICAT PRIMARY CARE LLC
Practice address
17833 Kuykendahl Rd
Spring, TX 77379-1109
Phone
(328) 698-2127
Fax
(832) 698-2976
NPI assigned
Feb 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Araceli Amador, MDNPI 1881891489
Title
Medical Director
Phone
(832) 698-2127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

17833 Kuykendahl Rd
Spring, TX 77379-1109

Mailing address

17833 Kuykendahl Rd
Spring, TX 77379-1109
Phone (832) 610-7225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170915000040 TX Part B Supplier - Clinic/Group Practice 5496029472 Receives reassigned benefits from 1 practitioner
Practice locations: Spring, TX

National Provider Directory

National Provider Directory

Locations

17835 Kuykendahl Rd
Spring, TX 77379

17835 Kuykendahl Rd
Ste 103
Spring, TX 77379
Phone (713) 955-2333

17833 Kuykendahl Rd
Ste B
Spring, TX 77379

17833 Kuykendahl Rd
Ste 103
Spring, TX 77379

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1063950459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17833 KUYKENDAHL RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773791109",
            "telephone_number": "832-610-7225",
            "fax_number": "832-698-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17833 KUYKENDAHL RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773791109",
            "telephone_number": "328-698-2127",
            "fax_number": "832-698-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNIFICAT PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "AMADOR",
        "authorized_official_first_name": "ARACELI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "832-698-2127",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.