Individual provider Active NPI

Alexa Medrano, PA-C

  • Physician Assistant
  • Laredo, TX
National Provider Identifier
1407304173
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10732 Issued in TX
Practice address
7109 N Bartlett Ave Ste 109
Laredo, TX 78041-6473
Phone
(956) 727-2122
Fax
(956) 718-6294
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10732 TX Primary

Addresses

Primary practice location

7109 N Bartlett Ave Ste 109
Laredo, TX 78041-6473

Mailing address

PO Box 3397
Laredo, TX 78044-3397
Phone (956) 718-6259

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA10732TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Laredo Sports Medicine Clinic, PA PastSince Mar 4, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alexa.medrano.1@28730.direct.athenahealth.com

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1407304173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3397",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780443397",
            "telephone_number": "956-718-6259",
            "fax_number": "956-718-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 N BARTLETT AVE STE 109",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416473",
            "telephone_number": "956-727-2122",
            "fax_number": "956-718-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "ALEXA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.