NPIMap

Organization Active NPI

Mid Coast Health System

Doing business as MidCoast Medical Center - Sealy

  • Emergency Medicine Physician
  • Sealy, TX
National Provider Identifier
1154036861
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MID COAST HEALTH SYSTEM
Doing business as
MidCoast Medical Center - Sealy
Practice address
1036 N Circle Dr
Sealy, TX 77474-3336
Phone
(979) 413-7400
Fax
(979) 413-7190
NPI assigned
Jan 17, 2023
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Mr. David H Mak
Title
Chief Financial Officer
Phone
(979) 543-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1036 N Circle Dr
Sealy, TX 77474-3336

Mailing address

303 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (979) 543-6251

Other names 1

  • MidCoast Medical Center - Sealy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210506000385 TX Part B Supplier - Clinic/Group Practice 8224442025 Receives reassigned benefits from 46 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 7

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1154036861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SANDY CORNER RD",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774379535",
            "telephone_number": "979-543-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 N CIRCLE DR",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774743336",
            "telephone_number": "979-413-7400",
            "fax_number": "979-413-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COAST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "MAK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "979-543-6251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MidCoast Medical Center - Sealy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sealy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.