Individual provider Active NPI

Bertha Laura Rodriguez-Medina, MD

  • Family Medicine Physician
  • McAllen, TX
National Provider Identifier
1811048143
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G-7102 Issued in TX
Practice address
721 Savannah Ave
McAllen, TX 78503-3006
Phone
(956) 630-5585
Fax
(956) 630-0438
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 G-7102 TX Primary

Addresses

Primary practice location

721 Savannah Ave
McAllen, TX 78503-3006

Mailing address

721 Savannah Ave
McAllen, TX 78503-3006
Phone (956) 630-5585

Other identifiers 1

IdentifierTypeStateIssuer
0805541-01MedicaidTX

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
I20120516000265 TX Practitioner - Family Practice 2860655628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bertha Laura R Medina MD PAGroup PAC ID 1951564715, 2 clinicians

Practice addresses (Care Compare)

721 Savannah Ave
McAllen, TX 78503-3006
Phone (956) 630-5585

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bertha Laura R Medina MD PA Family Medicine CurrentSince Jul 1, 1997 Accepting new patients
Southside Night Clinic Family Medicine CurrentSince Jun 6, 2016 Accepting new patients
Doctors Hospital at Renaissance, LTD Past Accepting new patients

Locations

721 Savannah Ave
McAllen, TX 78503
Phone (956) 630-5585

717 Savannah Ave
McAllen, TX 78503
Phone (956) 631-5995

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3fe59471-3589-4f65-b447-b92822bfc057/

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.

Hospital & facility affiliations 2

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1811048143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SAVANNAH AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785033006",
            "telephone_number": "956-630-5585",
            "fax_number": "956-630-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SAVANNAH AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785033006",
            "telephone_number": "956-630-5585",
            "fax_number": "956-630-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-MEDINA",
        "first_name": "BERTHA LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G-7102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805541-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.