Individual provider Active NPI

Madeline Elizabeth Clark, MD

  • Obstetrics & Gynecology Physician
  • Houston, TX
National Provider Identifier
1124581269
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
U5373 Issued in TX
Practice address
1 Baylor PLZ
Houston, TX 77030-3411
Phone
(713) 798-4951
NPI assigned
Apr 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X U5373 TX Primary

Addresses

Primary practice location

1 Baylor PLZ
Houston, TX 77030-3411

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

13105 Wortham Center Dr
Houston, TX 77065-5611
Phone (713) 442-4000

Other practice location 2

27020 Northwest Freeway
Cypress, TX 77433-7974
Phone (713) 442-8400

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
I20230807003279 TX Practitioner - Obstetrics/Gynecology 1557722519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at Houston, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

27020 Northwest Fwy
Cypress, TX 77433-7974
Phone (713) 442-8400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U5373TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Obstetrics & Gynecology CurrentSince Sep 18, 2023 Accepting new patients

Locations

2414 University Blvd
Ste 200
Houston, TX 77005
Phone (713) 442-7300

13105 Wortham Center Dr
Houston, TX 77065
Phone (713) 442-4000

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

2414 University Blvd
Houston, TX 77005

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: mclark66120@direct.kelsey-seybold.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1124581269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "713-798-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13105 Wortham Center Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770655611",
            "country_code": "US",
            "telephone_number": "713-442-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27020 Northwest Freeway",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774337974",
            "country_code": "US",
            "telephone_number": "713-442-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MADELINE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-06",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "U5373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.