Individual provider Active NPI

Maximiliano Magallanes, MD

  • Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1285195016
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
V8677 Issued in TX
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-5800
Fax
(414) 805-8097
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 83602 WI
Surgery Physician 208600000X V8677 TX Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-5800

Other practice location 1

1224 3rd St Ste 8
Corpus Christi, TX 78404-2354
Phone (361) 985-9403

Other identifiers 1

IdentifierTypeStateIssuer
100283143MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TX2 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
I20240710000792 WI Practitioner - General Surgery 6305381799 Reassigns benefits to 1 organization
I20250722002563 TX Practitioner - General Surgery 6305381799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1224 3Rd St
Suite 8
Corpus Christi, TX 78404-2354
Phone (361) 985-9403

600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 881-3000

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

Hospital & facility affiliations

  • Christus Spohn Hospital Corpus Christi Hospital, Corpus Christi, TX, CCN 450046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83602WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Surgery CurrentSince Aug 1, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 8, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 8, 2025 Accepting new patients

Locations

1224 3rd St
Ste 8
Corpus Christi, TX 78404
Phone (361) 985-9403

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

Interoperability endpoints

  • Direct secure messaging: mmagallanes611075@christushealth.direct-ci.net

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.

Hospital & facility affiliations 1

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1285195016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5800",
            "fax_number": "414-805-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5800",
            "fax_number": "414-805-8097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 3rd St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784042354",
            "country_code": "US",
            "telephone_number": "361-985-9403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGALLANES",
        "first_name": "MAXIMILIANO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "83602",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "V8677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100283143",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.