Active NPI
Ben Medelez III, PTA
- Physical Therapy Assistant
- Brownsville, TX
National Provider Identifier
1194381616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2056760
- Practice address
- 4920 N. Expressway 77, Ste C
Brownsville, TX 78526 - Phone
- (956) 350-6696
- Fax
- (956) 350-6604
- NPI assigned
- May 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2056760 | TX | Primary |
Addresses
Primary practice location
4920 N. Expressway 77, Ste C
Brownsville, TX 78526
Mailing address
4920 N. Expressway 77, Ste C
Brownsville, TX 78526
Phone (956) 350-6696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2056760 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RGV Rehab North LLC | Past | Accepting new patients |
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Brownsville, TX
- NPI 1962557769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1194381616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 N. EXPRESSWAY 77, STE C",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "78526",
"telephone_number": "956-350-6696",
"fax_number": "956-350-6604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 N. EXPRESSWAY 77, STE C",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "78526",
"telephone_number": "956-350-6696",
"fax_number": "956-350-6604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDELEZ",
"first_name": "BEN",
"name_suffix": "III",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-10",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2056760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.