Kelly Maedo, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

L5032 Issued in TX

Practice address

3100 Buddy Owens Ave
McAllen, TX 78504-6464

Phone

(956) 971-0404

Fax

(956) 971-0408

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX2 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 2

Specialty

Dermatology

Education

Texas a & M University System, HSC, College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis Dermatology Group, PLLCGroup PAC ID 5890703508, 15 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Oasis Dermatology Group, PLLC

  dba Dermatology Clinic of McAllen

  • Dermatology Physician
  • McAllen, TX
  • NPI 1619099124
  Medicare reassignment Care Compare group NPD
• Altus Exceptional Physician Group PLLC

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1730869207
  Medicare reassignment NPD
• Emergency Hospital Systems LLC

  dba Cleveland Emergency Hospital

  • General Acute Care Hospital
  • Cleveland, TX
  • NPI 1992172019
  Medicare reassignment NPD
• Texas ER Group PLLC

  • Emergency Medicine Physician
  • Lumberton, TX
  • NPI 1235829359
  Medicare reassignment NPD
• TK Emergency Physicians Group PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1942728019
  Medicare reassignment NPD
• Family Practice Foundation of the Brazos Valley

  dba Family Medicine Center & Brazos Family Medicine Residency

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1578573531
  NPD (past)
• Oasis Dermatology Starr County PLLC

  dba Dermatology Clinic of Starr County

  • Dermatology Physician
  • Rio Grande City, TX
  • NPI 1093122723
  NPD (past)
• Texas a&M University System Health Science Center

  dba Texas A&M Physicians - Round Rock

  • General Practice Physician
  • Round Rock, TX
  • NPI 1992957963
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1104838887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 ROYAL ADELADE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454444",
            "telephone_number": "979-757-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 BUDDY OWENS AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785046464",
            "telephone_number": "956-971-0404",
            "fax_number": "956-971-0408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2911 Texas Ave S",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778455387",
            "country_code": "US",
            "telephone_number": "979-764-2882 x151",
            "fax_number": "979-764-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAEDO",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L5032",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157550803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S6084",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent R Macias, MD
• Mad Health Systems, LLC
• Raul Madrid-Linares, M. D.
• David Madrigal, FNP-C
• Marco Antonio Madrigal, PTA
• Albert Magallan Jr.
• Jacklin Renee Magallan, SLP
• America Montserrat Magana, SLP
• Magic Valley Home Health Care Inc
• Maharaj K. Razdan

• Dermatology Physician in McAllen, TX
• Providers in McAllen, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.