Mark Lane Madenwald, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

J2173 Issued in TX

Practice address

5304 Prince LN
Flower Mound, TX 75022-8103

Phone

(214) 734-4868

NPI assigned

Oct 6, 2005

Last updated

Sep 18, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Emergency Medicine

Education

University of Texas Medical Branch at Galveston, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Texas Health Harris Methodist Hospital Stephenvill Hospital, Stephenville, TX, CCN 450351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmadenwald355358@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment Care Compare group NPD
• Texas Medicine Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1376581900
  Medicare reassignment Care Compare group NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Concord North Texas, PLLC

  • Emergency Medicine Physician
  • Bonham, TX
  • NPI 1952761173
  Medicare reassignment NPD

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Stephenville

  • General Acute Care Hospital
  • Stephenville, TX
  • NPI 1922031541
  Care Compare affiliation

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1932197662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 PRINCE LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750228103",
            "telephone_number": "214-513-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 PRINCE LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750228103",
            "telephone_number": "214-734-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADENWALD",
        "first_name": "MARK",
        "middle_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J2173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "042138003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89532Z",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042138002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Stover Lungren, M.D.
• Luxottica of America Inc. (Lenscrafters #7033)
• Luxottica of America Inc. (Target Optical #2079)
• Molly Ruth Machemehl, MA LSSP
• Kristina Mackie, DDS
• Naga Sai Venkata Hanumantha Rao Madhavapeddi, M.D
• Kamryn Madkins
• Smridhi Mahajan, MD
• Grace Mahan
• Parisa Nehreen Mahmud, LPC ASSOCIATE

• Emergency Medicine Physician in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.