Individual provider Active NPI

Roy Dewayne Edwards, D.O.

  • Surgical Critical Care Physician
  • McAllen, TX
National Provider Identifier
1255530309
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
Q5178 Issued in TX
Practice address
1100 E Dove Ave Ste 300
McAllen, TX 78504-4682
Phone
(956) 362-8170
Fax
(956) 362-8168
NPI assigned
Jul 17, 2007
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q5178 TX
Surgical Critical Care Physician 2086S0102X Q5178 TX Primary
Military Health Care Provider 171000000X NU

Addresses

Primary practice location

1100 E Dove Ave Ste 300
McAllen, TX 78504-4682

Mailing address

PO Box 2975
McAllen, TX 78502-2975
Phone (956) 362-8170

Other identifiers 1

IdentifierTypeStateIssuer
Q5178OtherTXTEXAS MEDICAL BOARD LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160712000552 TX Practitioner - General Surgery 9335382076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
West Virginia School of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Specialty SurgeryGroup PAC ID 8628291820, 26 clinicians

Practice addresses (Care Compare)

4770 N Expressway
Suite 303
Brownsville, TX 78526-3108
Phone (956) 362-3715

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.16 of 100Reported as group
Quality
80.62
Improvement activities
40
Cost
69.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5178TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Specialty Surgery Surgery CurrentSince Aug 4, 2021 Accepting new patients
Doctors Hospital at Renaissance, LTD Past Accepting new patients

Locations

4770 N Expressway
Ste 202
Brownsville, TX 78526
Phone (956) 362-3715

4770 N Expressway
Ste 305A
Brownsville, TX 78526
Phone (956) 362-3980

4770 N Expressway 77 83
Ste 303
Brownsville, TX 78526
Phone (956) 362-3715

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

1100 E Dove Ave
Ste 300
McAllen, TX 78504
Phone (956) 362-8170

2795 Pharmacy Rd
Rio Grande Cy, TX 78582
Phone (956) 317-1485

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3fe59471-3589-4f65-b447-b92822bfc057/

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1255530309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2975",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785022975",
            "telephone_number": "956-362-8170",
            "fax_number": "956-362-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E DOVE AVE STE 300",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785044682",
            "telephone_number": "956-362-8170",
            "fax_number": "956-362-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROY",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q5178",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "Q5178",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD LICENSE",
            "identifier": "Q5178",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.