Individual provider Active NPI

Rea Marouf Cleland, MD, MS

  • Student in an Organized Health Care Education/Training Program
  • San Antonio, TX
National Provider Identifier
1417699968
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4502 Medical Dr
San Antonio, TX 78229-4492
Phone
(210) 358-4000
NPI assigned
Apr 13, 2022
Last updated
May 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4492

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL clelandr@uthscsa.edu Direct UTHSCSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251218002405 KY Practitioner - Pediatric Medicine 3971098815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1951 Bishop LN
FL 4
Louisville, KY 40218-1923

P O Box
Suite 776879
Chicago, IL 60677-6879

PO Box
Suite 776879
Chicago, IL 60677-6879

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC CurrentSince Dec 1, 2025 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1417699968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294492",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELAND",
        "first_name": "REA",
        "middle_name": "MAROUF",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clelandr@uthscsa.edu",
            "affiliation": "Y",
            "endpointDescription": "Employee email",
            "affiliationName": "UTHSCSA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4502 Medical Dr",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782294492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.