Glen A. Medellin, M.D.

Primary specialty

Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X

License

K3796 Issued in TX

Practice address

903 W Martin St
San Antonio, TX 78207-0903

Phone

(210) 358-9658

Fax

(210) 358-3450

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Hospice/Palliative Care

Education

University of Texas Medical Branch at Galveston, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Health System Hospital, San Antonio, TX, CCN 450213

Merit-based Incentive Payment System (MIPS)

Final score

96.65 of 100Reported as group

Quality

83.62

Promoting interoperability

100

Improvement activities

40

Cost

78.03

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmedellin46902@uhssa.direct-ci.com

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.

• Community Medicine Associates

  dba University Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329

  Pediatrics

  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Pediatrics

  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Imaging

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD
• Pain Management Specialists

  dba Medical Practice

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1922617125
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bexar County Hospital District

  dba University Health

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1689686610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9172",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-9658",
            "fax_number": "210-358-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDELLIN",
        "first_name": "GLEN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K3796",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "K3796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "125095309",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125095307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125095308",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "125095307",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Medel, PHARMD
• Robert Joseph Medell, M.D.
• Cecilia Medellin Arambula
• Denisse Medellin
• Elisa Medellin, LPC
• Gustavo Javier Medellin, MD
• Jesse E Medellin
• Lorena Medellin, LCSW
• Megan Celeste Medellin, NP
• Michelle V Medellin, M.D.

• Pediatric Hospice and Palliative Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Hospice and Palliative Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.

Verify at the official NPI Registry.