Ag Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AG MEDICAL PLLC

Doing business as

Acevedo Pediatric Clinic

Practice address

2412 N Conway Ave
Mission, TX 78574-2347

Phone

(956) 833-5437

Fax

(956) 833-5444

NPI assigned

May 23, 2022

Last updated

Apr 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roberto Acevedo, NPNPI 1669873717

Title

President

Phone

(956) 529-2202

Specialties & licenses 2

Addresses

Other names 1

• ACEVEDO PEDIATRIC CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roberto Acevedo, NP

  • Nurse Practitioner
  • Mission, TX
  • NPI 1669873717
  Medicare reassignment NPD Authorized official
• Gustavo F Olivares, P.A.

  • Physician Assistant
  • McAllen, TX
  • NPI 1497997571
  Medicare reassignment
• Ivan G Melendez, M.D.

  • Family Medicine Physician
  • McAllen, TX
  • NPI 1568447233
  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1265170948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742347",
            "telephone_number": "956-833-5437",
            "fax_number": "956-833-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742347",
            "telephone_number": "956-833-5437",
            "fax_number": "956-833-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4836 S Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785396539",
            "country_code": "US",
            "telephone_number": "956-833-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AG MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-529-2202",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACEVEDO PEDIATRIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ACEVEDO PEDIATRIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Mission, TX
• Providers in Mission, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.