Robert Michael Mena, MD
Individual provider Active NPI Family Medicine Physician · Winnie, TX
NPI 1073657482 · NPPES record last updated Mar 2, 2022
Key facts
- NPI
- 1073657482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M8898 (ID)
- Practice address
- 538 Broadway
Winnie, TX 77665-7600 - Phone
- (409) 296-6000
- NPI assigned
- Feb 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 21
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gonzales Healthcare Systems
Practice addresses (Care Compare)
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Phone (830) 672-7581
Hospital & facility affiliations
- Dimmit Regional Hospital
- Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210701000190 | TX | Practitioner - Family Practice | 5890682272 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8898 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dimmit Regional Hospital | Multi-Specialty | Current |
Accepting new patients |
| Concord Medical Group PLLC | Multi-Specialty | Current |
Accepting new patients |
| Dimmit Regional Hospital | Multi-Specialty | Current | Accepting new patients |
| Dimmit Regional Hospital | Multi-Specialty | Current |
Accepting new patients |
| Gonzales Healthcare Systems | Current |
Accepting new patients | |
| Winnie Community Hospital, L.L.C. | Multi-Specialty | Current |
Accepting new patients |
| Concord Medical Group of Texas PLLC | Multi-Specialty | Current |
Accepting new patients |
| Winnie Community Hospital LLC | Multi-Specialty | Current | Accepting new patients |
| Gonzales Healthcare Systems | Multi-Specialty | Current |
Accepting new patients |
| Psychiatric Services, PA | Multi-Specialty | Past | Accepting new patients |
| Kootenai Health, Inc. | Multi-Specialty | Past | Accepting new patients |
| Winnie Community Hospital, LLC | Past | Accepting new patients | |
| Psychiatric Services Behavioral Health Clinic Inc | Multi-Specialty | Past | Accepting new patients |
| Wasatch Hyperbaric Center Inc | Multi-Specialty | Past | Accepting new patients |
Locations
200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241
705 E Felt St
Brownfield, TX 79316
Phone (806) 637-1955
504 Hospital Dr
Ste B
Carrizo Springs, TX 78834
Phone (830) 876-9458
304 S 5th St
Carrizo Springs, TX 78834
Phone (830) 876-9421
704 Hospital Dr
Carrizo Springs, TX 78834
Phone (830) 876-2424
6130 Parkway Dr
Corpus Christi, TX 78414
Phone (361) 826-5785
1313 Veterans Ave
Ste A
Crystal City, TX 78839
Phone (830) 374-9823
1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845
310 W South St
Henrietta, TX 76365
Phone (806) 647-2191
540 W 15th St
Hereford, TX 79045
Phone (806) 364-2141
3623 S Main St
Ste 109
Stafford, TX 77477
Phone (281) 969-7643
538 Broadway
Winnie, TX 77665
Phone (409) 296-6000
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/bfa557fc-696e-49f4-8d78-7cdfe1e82721/
- https://fhir-usa.unify.chbase.com/org/dimmit-a3ff579f
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | T0566 | TX | |
| Family Medicine Physician | 207Q00000X | M8898 | ID | Yes |
Addresses
Primary practice location
538 Broadway
Winnie, TX 77665-7600
Mailing address
718 Avenue a
Winnie, TX 77665-8890
Other practice location 1
1100 N Lincoln Ave
Jerome, ID 83338-1856
Phone (208) 324-6656
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55392 | Other | ID | BLUE CROSS |
| 1111689 | Other | ID | MEDICARE |
| 000010144342 | Other | ID | BLUE SHIELD OF IDAHO |
| 806670100 | Medicaid | ID | |
| 820227163B004 | Other | ID | TRICARE |
| 820227163G041 | Other | ID | TRICARE |
| 000010144054 | Other | ID | BLUE SHIELD OF IDAHO |
| 553925 | Other | ID | BLUE CROSS OF IDAHO |
| J9430 | Other | ID | BLUE CROSS OF IDAHO |
Other providers in Winnie, TX
- Felix C Jackson
- Kaycie Landry
- Taylor Brooke Ledoux
- Michael Lyons
- Kristina Marie May
- Benjamin Scott Odom
- Joshua Alan Olmstead
- Angela Phifer
- Kevin M Prince
- Hallie Rogers
All providers in Winnie, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.