Individual provider Active NPI

Sandra Milena Amado Medina, M.D.

  • Family Medicine Physician
  • Katy, TX
National Provider Identifier
1114362985
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q5141 Issued in TX
Practice address
26077 Nelson Way
Suite 301
Katy, TX 77494-5642
Phone
(832) 882-5632
Fax
(832) 553-2686
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5141 TX Primary

Addresses

Primary practice location

26077 Nelson Way
Suite 301
Katy, TX 77494-5642

Mailing address

26077 Nelson Way
Ste 301
Katy, TX 77494-6677
Phone (832) 228-2005

Other identifiers 1

IdentifierTypeStateIssuer
356715802MedicaidTX

Other names 1

  • Sandra Milena Amado Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160308001617 TX Practitioner - Family Practice 3577871755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amado Holistics PLLCGroup PAC ID 9436551066, 2 clinicians

Practice addresses (Care Compare)

26077 Nelson Way
Suite 301
Katy, TX 77494-5642

409 Branchwood LN
Brookshire, TX 77423-3221
Phone (832) 882-5632

Hospital & facility affiliations

  • Memorial Hermann Katy Hospital Hospital, Katy, TX, CCN 450847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5141TXMDFamily Medicine Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1114362985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26077 NELSON WAY",
            "address_2": "STE 301",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946677",
            "telephone_number": "832-228-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26077 NELSON WAY",
            "address_2": "SUITE 301",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945642",
            "telephone_number": "832-882-5632",
            "fax_number": "832-553-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADO MEDINA",
        "first_name": "SANDRA",
        "middle_name": "MILENA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356715802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "AMADO",
            "middle_name": "MILENA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.