John Albert Maldonado II, MD
Individual provider Active NPI Family Medicine Physician · Fernley, NV
NPI 1124517412 · NPPES record last updated Jul 6, 2021
Key facts
- NPI
- 1124517412
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20949 (NV)
- Practice address
- 1260 Nevada Pacific Blvd
Fernley, NV 89408-9871 - Phone
- (775) 575-7171
- Fax
- (775) 575-7227
- NPI assigned
- May 2, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Churchill Community Hospital
Saint Marys Urgent Care LLC
Practice addresses (Care Compare)
1260 Nevada Pacific Blvd
Fernley, NV 89408-9871
Phone (775) 575-7171
18653 Wedge Pkwy
Suite 300
Reno, NV 89511-3038
Phone (775) 770-7210
Hospital & facility affiliations
- Centerwell Home Health
- Eden Home Health
- Banner Churchill Community Hospital
- Renown Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- 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 |
|---|---|---|---|---|
| I20210803003335 | NV | Practitioner - Family Practice | 3072917749 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20949 | NV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Marys Medical Group Inc. | Current | Accepting new patients | |
| CH Specialty Services NV Requeijo PC | Current |
Accepting new patients | |
| Saint Marys Urgent Care LLC | Current |
Accepting new patients | |
| Curana Health of Nevada PLLC | Current |
Accepting new patients | |
| Banner Churchill Community Hospital | Current |
Accepting new patients | |
| Mt Grant General Hospital | Past | Accepting new patients | |
| Banner Churchill Community Hospital | Past | Accepting new patients | |
| South Lyon Health Center, Inc. | Past | Accepting new patients | |
| Prime Healthcare Services - Reno LLC | Past | Accepting new patients | |
| Sparks Family Hospital Inc | Past | Accepting new patients |
Locations
1801 W Olympic Blvd
#1461
Pasadena, CA 91199
1001 Mountain St
Carson City, NV 89703
Phone (775) 222-0045
801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310
1260 Nevada Pacific Blvd
Fernley, NV 89408
Phone (775) 442-0683
5351 Montessouri St
Las Vegas, NV 89113
Phone (702) 251-2200
411 W 6th St
Reno, NV 89503
Phone (775) 770-3209
18653 Wedge Pkwy
Ste 300
Reno, NV 89511
Phone (775) 770-7210
Interoperability endpoints
- john.maldonado@direct.myhealthep.org
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TX | ||
| Family Medicine Physician | 207Q00000X | 20949 | NV | Yes |
Addresses
Primary practice location
1260 Nevada Pacific Blvd
Fernley, NV 89408-9871
Mailing address
1260 Nevada Pacific Blvd
Fernley, NV 89408-9871
Phone (775) 575-7171
Other practice location 1
9849 Kenworthy St
El Paso, TX 79924-4402
Phone (915) 215-5550
Other providers in Fernley, NV
- Kristin Anne Laxalt
- Bridgette Lesar
- Sandra B Lopez-Martinez
- Bryan Lott
- Christine Love
- Patricia C Marinelli
- Eloisa Martinez
- Melissa Louise May
- Terri Ellen May
- Seth McBride
All providers in Fernley, NV · Family Medicine Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2021. 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.