Active NPI
Mary Jane Hortelano Cubillas, CNP
- Primary Care Nurse Practitioner
- Edinburg, TX
National Provider Identifier
1356065320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 1076370
- Practice address
- 122 W Champion St
Edinburg, TX 78539-4429 - Phone
- (195) 628-7120
- Fax
- (956) 287-1292
- NPI assigned
- Oct 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1076370 | TX | Primary |
Addresses
Primary practice location
122 W Champion St
Edinburg, TX 78539-4429
Mailing address
1113 W Chapin St
Edinburg, TX 78541-2316
Phone (956) 429-1134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://txgwmcapp.eclinicalweb.com/mobiledoc/jsp/webemr/login/newLogin.jsp | Health Information Exchange (HIE) |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221017002594 | TX | Practitioner - Nurse Practitioner | 6305212341 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
122 W Champion St
Edinburg, TX 78539-4429
Hospital & facility affiliations
- Doctors Hosptal at Renaissance
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1076370 | TX | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Antonio Wong,MD & Associates,PA | Current | Accepting new patients |
Locations
122 W Champion St
Edinburg, TX 78539
Phone (956) 287-1207
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.
-
- Internal Medicine Physician
- Edinburg, TX
- NPI 1770604688
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Edinburg, TX
- NPI 1053317362
-
- Transplant Surgery Physician
- McAllen, TX
- NPI 1104338052
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1356065320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1113 W CHAPIN ST",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785412316",
"telephone_number": "956-429-1134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 W CHAMPION ST",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785394429",
"telephone_number": "195-628-7120",
"fax_number": "956-287-1292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORTELANO CUBILLAS",
"first_name": "MARY JANE",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "1076370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://txgwmcapp.eclinicalweb.com/mobiledoc/jsp/webemr/login/newLogin.jsp",
"affiliation": "N",
"endpointDescription": "eClinicalWorks",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "122 W Champion St",
"city": "Edinburg",
"state": "TX",
"country_code": "US",
"postal_code": "785394429",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.