Individual provider Active NPI

Miguel Torres Medrano, NP

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1265028476
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1021115 Issued in TX
Practice address
600 Columbus Ave Ste 106
Waco, TX 76701-1322
Phone
(254) 405-4537
Fax
(855) 226-8732
NPI assigned
Dec 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1021115 TX Primary

Addresses

Primary practice location

600 Columbus Ave Ste 106
Waco, TX 76701-1322

Mailing address

600 Columbus Ave Ste 106
Waco, TX 76701-1322
Phone (254) 405-4537

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210112001406 TX Practitioner - Nurse Practitioner 5193138162 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1021115TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Infusions, LLC CurrentSince Nov 3, 2022 Accepting new patients
Innovative Infusions, LLC CurrentSince Nov 3, 2022 Accepting new patients
Premier House Calls PLLC CurrentSince May 29, 2022 Accepting new patients

Locations

200 N Mesquite St
Ste 115
Arlington, TX 76011
Phone (817) 200-2530

720 W 34th St
Ste 104
Austin, TX 78705
Phone (512) 261-4800

4710 Bellaire Blvd
Ste 340
Bellaire, TX 77401
Phone (713) 860-1755

11317 N Central Expy
Ste 100
Dallas, TX 75243
Phone (972) 408-2777

1650 Round Rock Ave
Ste 200
Round Rock, TX 78681
Phone (737) 443-5230

1922 Dry Creek Way
Ste 134
San Antonio, TX 78259
Phone (210) 485-3700

600 Columbus Ave
Ste 106
Waco, TX 76701
Phone (254) 405-4537

2320 W Loop 340
Ste 100B
Waco, TX 76711
Phone (254) 730-4168

605 Austin Ave
Waco, TX 76701
Phone (254) 405-4537

Organizations & group practices 3

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": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1265028476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COLUMBUS AVE STE 106",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011322",
            "telephone_number": "254-405-4537",
            "fax_number": "855-226-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COLUMBUS AVE STE 106",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011322",
            "telephone_number": "254-405-4537",
            "fax_number": "855-226-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES MEDRANO",
        "first_name": "MIGUEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-12",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1021115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.