NPIMap

Individual provider Active NPI

Pedro Antonio Maldonado, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • El Paso, TX
National Provider Identifier
1407090319
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
P6455 Issued in TX
Practice address
4801 Alberta Ave
Texas Tech University Health Sciences Center- El Paso
El Paso, TX 79905-2707
Phone
(915) 215-5099
Fax
(915) 215-8660
NPI assigned
Apr 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X P6455 TX
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X P6455 TX Primary

Addresses

Primary practice location

4801 Alberta Ave
Texas Tech University Health Sciences Center- El Paso
El Paso, TX 79905-2707

Mailing address

5130 Gateway Blvd E # 51015
El Paso, TX 79905-1608
Phone (915) 215-4480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130712000123 TX Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 3779723895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Obstetrics & Gynecology CurrentSince Aug 1, 2016 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2016 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2013 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology CurrentSince Jul 1, 2013 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: pedro.maldonado@direct.myhealthep.org

Organizations & group practices 6

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 3

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": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1407090319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 GATEWAY BLVD E # 51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051608",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "address_2": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER- EL PASO",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052707",
            "telephone_number": "915-215-5099",
            "fax_number": "915-215-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "PEDRO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P6455",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TX",
            "license": "P6455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.