Marinel M Munda, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L5505 Issued in TX

Practice address

1000 E 5TH St
Tyler, TX 75701-3315

Phone

(903) 590-5555

Fax

(903) 590-5005

NPI assigned

Jun 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marinel Munda Pamatmat Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmunda355038@ahs.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 and National Provider Directory roles.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1881620433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3588",
            "fax_number": "903-594-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013315",
            "telephone_number": "903-590-5555",
            "fax_number": "903-590-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDA",
        "first_name": "MARINEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L5505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155536903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINEL",
            "last_name": "PAMATMAT",
            "middle_name": "MUNDA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christopher Daniel Mullins
• Clifford David Mullins, D.C.
• Heather Mullins
• Sanober Humayum Mumtaz, MD
• Jessica Munch
• Leticia Munoz
• Nora Munoz
• Megan Murdick
• Randy Tucker Murff, DPM
• Erica Muriel

• Pediatrics Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.