Individual provider Active NPI

Malea Pruszenski Maynard, M.D.

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1740219229
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K7451 Issued in TX
Practice address
13350 Ti Blvd
M/S 327
Dallas, TX 75243-1512
Phone
(972) 671-9504
Fax
(972) 671-7096
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K7451 TX Primary

Addresses

Primary practice location

13350 Ti Blvd
M/S 327
Dallas, TX 75243-1512

Mailing address

8080 N Central Expy
Suite 1650
Dallas, TX 75206-1838
Phone (972) 860-8648

Other identifiers 2

IdentifierTypeStateIssuer
P00240298OtherTXRR MEDICARE
8147K4OtherTXBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmaynard222491@direct.sw.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000331 TX Practitioner - Family Practice 5991832701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

13350 T I Blvd
Dallas, TX 75243-1512
Phone (972) 671-9504

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Baylor Scott and White Medical Center McKinney Hospital, MC Kinney, TX, CCN 670082
  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 8, 2000 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince May 8, 2000 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

13350 T I Blvd
Ste MS327
Dallas, TX 75243

13350 Ti Blvd
#327
Dallas, TX 75243
Phone (972) 671-9504

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

8080 N Central Expy
Ste 1650
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1740219229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N CENTRAL EXPY",
            "address_2": "SUITE 1650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061838",
            "telephone_number": "972-860-8648",
            "fax_number": "972-860-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13350 TI BLVD",
            "address_2": "M/S 327",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431512",
            "telephone_number": "972-671-9504",
            "fax_number": "972-671-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MALEA",
        "middle_name": "PRUSZENSKI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00240298",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8147K4",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaynard222491@direct.sw.org",
            "affiliation": "N",
            "address_1": "13350 Ti Blvd",
            "address_2": "M/S 327",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752431512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.