Roland A Medellin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H9467 Issued in TX

Practice address

228 Saint George St
Gonzales, TX 78629-3910

Phone

(830) 672-6511

Fax

(830) 672-6430

NPI assigned

Aug 11, 2005

Last updated

Aug 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Emergency MedicineAlso: Family Practice

Education

Warren Alpert Medical School of Brown University, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lone Star Emergency Associates LLCGroup PAC ID 7113054446, 13 clinicians

Community Health Centers of South Central Texas, Inc.Group PAC ID 4688650328, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yoakum Community Hospital Hospital, Yoakum, TX, CCN 451346

Merit-based Incentive Payment System (MIPS)

Final score

95.72 of 100Reported as group

Quality

91.03

Improvement activities

40

Cost

86.6

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Centers of South Central Texas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gonzales, TX
  • NPI 1285650424
  Medicare reassignment Care Compare group NPD
• Lone Star Emergency Associates LLC

  • Emergency Medicine Physician
  • Victoria, TX
  • NPI 1457709040
  Medicare reassignment Care Compare group NPD
• Jackson County Hospital District

  dba Jackson HealthCare Center

  • Critical Access Hospital
  • Edna, TX
  • NPI 1124061882
  Medicare reassignment NPD
• Jackson County Hospital District

  dba Jackson County Hospital Physicians Group

  • Emergency Medicine Physician
  • Edna, TX
  • NPI 1215971478
  Medicare reassignment NPD
• Texas Emergency Group LLC

  • Emergency Medicine Physician
  • Cuero, TX
  • NPI 1699288811
  Medicare reassignment NPD
• Victoria Emergency Associates LLC

  • Emergency Medicine Physician
  • Victoria, TX
  • NPI 1407917164
  Medicare reassignment NPD
• Victoria Emergency Partners LLC

  • Emergency Medicine Physician
  • Gonzales, TX
  • NPI 1164770996
  Medicare reassignment NPD
• Community Health Centers of South Central Texas, Inc.

  dba Bastrop ISD Health Center

  • Federally Qualified Health Center (FQHC)
  • Bastrop, TX
  • NPI 1407406333
  NPD
• Community Health Centers of South Central Texas, Inc.

  dba Women's Health and WIC Center

  • Federally Qualified Health Center (FQHC)
  • Gonzales, TX
  • NPI 1467756247
  NPD
• Jackson County Hospital District

  dba Jackson County Medical Clinic of Ganado

  • Rural Health Clinic/Center
  • Ganado, TX
  • NPI 1679445654
  NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)
• Community Health Centers of South Central Texas Inc.

  dba Bastrop Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bastrop, TX
  • NPI 1629471875
  NPD (past)

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

• Yoakum Community Hospital

  • Critical Access Hospital
  • Yoakum, TX
  • NPI 1881697878
  Care Compare affiliation

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1184626871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 SAINT GEORGE ST",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293910",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 SAINT GEORGE ST",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293910",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDELLIN",
        "first_name": "ROLAND",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H9467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE",
            "identifier": "H9467",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128480406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Isabel Martinez, LVN
• Maribel Matamoros, LVN
• Katherine Lindsay Mauermann, CPHT
• Dawn Marie McGill
• Marquish McKinnon
• David K Meredith, D.O.
• Michael Mikesh
• Diana Marie Mikulencak-Picha, NP-C
• Mohrmann's Drug Store LLC
• Antonie Moltz Morgan, PHYSICIAN ASSISTANT

• Family Medicine Physician in Gonzales, TX
• Providers in Gonzales, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.