Individual provider Active NPI

Amanda B. Reed-Maldonado, MD

  • Urology Physician
  • Fort Sam Houston, TX
National Provider Identifier
1255516142
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
T2735 Issued in TX
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 539-9582
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD-20325 HI
Urology Physician 208800000X MD60746380 WA
Urology Physician 208800000X T2735 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone (210) 916-7884

Other practice location 1

Madigan Army Medical Center
Tacoma, WA 98431-2028
Phone (253) 968-2300

Other practice location 2

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-2595 ext. 4

Other practice location 3

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 539-9582

Other practice location 4

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other names 1

  • Dr. Amanda B. Reed-Maldonado Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150622001391 CA Practitioner - Urology 0345551099 Reassigns benefits to 1 organization
I20180403001597 WA Practitioner - Urology 0345551099 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-20325HIMDUrology Physician
T2735TXMDUrology Physician
MD60746380WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Apr 30, 2018 Accepting new patients
Multicare Health System CurrentSince Apr 30, 2018 Accepting new patients
University of California SFGH Medical Group CurrentSince Jun 15, 2015 Accepting new patients
University of California SFGH Medical Group Urology CurrentSince Jun 15, 2015 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

1001 Potrero Ave
Rm 3A20
San Francisco, CA 94110
Phone (415) 206-8806

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 5

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1255516142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7884",
            "fax_number": "210-916-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Madigan Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984312028",
            "country_code": "US",
            "telephone_number": "253-968-2300",
            "fax_number": "253-968-2895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2595 x4",
            "fax_number": "808-433-7149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-539-9582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 N Chelan Ave",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "988012028",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED-MALDONADO",
        "first_name": "AMANDA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "HI",
            "license": "MD-20325",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60746380",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "T2735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "REED-MALDONADO",
            "middle_name": "B.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.