Ivan A Mederos, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

J7581 Issued in TX

Practice address

1710 E Saunders St
Suite B-375
Laredo, TX 78041-5443

Phone

(956) 795-8297

Fax

(956) 794-8888

NPI assigned

Feb 9, 2006

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 1

Electronic endpoints 1

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

General Surgery

Education

Wake Forest University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Employee Assistance Program IncGroup PAC ID 1557260064, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Laredo Medical Center Hospital, Laredo, TX, CCN 450029

Merit-based Incentive Payment System (MIPS)

Final score

88.18 of 100Reported as apm

Quality

71.02

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984

  Surgery

  Medicare reassignment Care Compare group NPD
• Timberland Medical Group

  • Family Medicine Physician
  • Cedar Park, TX
  • NPI 1528061157

  Surgery

  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Timberland Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Cedar Park, TX
  • NPI 1023790045
  NPD
• Laredo Texas Hospital Company LP

  • General Acute Care Hospital
  • Laredo, TX
  • NPI 1548232044
  NPD (past)

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

• Laredo Texas Hospital Company LP

  • General Acute Care Hospital
  • Laredo, TX
  • NPI 1548232044
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1205809258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450748",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780450018",
            "telephone_number": "956-795-8297",
            "fax_number": "956-794-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 E SAUNDERS ST",
            "address_2": "SUITE B-375",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415443",
            "telephone_number": "956-795-8297",
            "fax_number": "956-794-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEROS",
        "first_name": "IVAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J7581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102583501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ivan.mederos.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1710 E Saunders St",
            "address_2": "Suite B-375",
            "city": "Laredo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780415443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mdig of Texas PLLC
• Adam Leon Mecham, D.C.
• Med Equip Medical Rentals Inc
• Medcare Plus Solutions Medical Equipment & Supplies, LLC
• Medcore Diagnostics LLC
• Medica 2000 USA LLC
• Medical Ambulance Services,Inc
• Medical Billing & Equipment of Texas LLC
• Christina Marie Medina, SLP ASSISTANT
• Dianna Michelle Medina, MOT

• Surgery Physician in Laredo, TX
• Providers in Laredo, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.