Individual provider Active NPI

Roxana Pagan-Maldonado, MD

  • Family Medicine Physician
  • Harlingen, TX
National Provider Identifier
1285624924
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J5435 Issued in TX
Practice address
512 Victoria LN
Suite #4
Harlingen, TX 78550-3226
Phone
(956) 421-5202
Fax
(956) 421-5238
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J5435 TX Primary

Addresses

Primary practice location

512 Victoria LN
Suite #4
Harlingen, TX 78550-3226

Mailing address

512 Victoria Lane
Suite #4
Harlingen, TX 78550-3207
Phone (956) 421-5202

Other identifiers 1

IdentifierTypeStateIssuer
116772803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Diagnostic Clinic PA Past Accepting new patients

Organizations & group practices 1

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1285624924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LANE",
            "address_2": "SUITE #4",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503207",
            "telephone_number": "956-421-5202",
            "fax_number": "956-421-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN",
            "address_2": "SUITE #4",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503226",
            "telephone_number": "956-421-5202",
            "fax_number": "956-421-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN-MALDONADO",
        "first_name": "ROXANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J5435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116772803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.