Madonna M Mamerow, PHD, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT86015 Issued in TX

Practice address

2600 S Shore Blvd Ste 300
League City, TX 77573-2944

Phone

(281) 436-9668

Fax

(833) 259-9548

NPI assigned

Jun 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Donna M Victor Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Victor Nutrition, LLC

  • Registered Dietitian
  • League City, TX
  • NPI 1023654670
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1104488220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 433",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775530433",
            "telephone_number": "281-436-9668",
            "fax_number": "833-259-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S SHORE BLVD STE 300",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732944",
            "telephone_number": "281-436-9668",
            "fax_number": "833-259-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMEROW",
        "first_name": "MADONNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "VICTOR",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PHD, RD, LD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Misty Malady
• Felix Maldonado Chapa, MD
• Asif Malik
• Rachael Elizabeth Maly
• Heather Mambretti, PA-C
• Sarah Grace Mamud, MS, BCBA
• Giselle Mancinas, SLP INTERN
• Diane Ruth Manley, LPC
• Tariq Mansuri
• Nikhil Mantravadi

• Registered Dietitian in League City, TX
• Providers in League City, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.