MARY BETH MADONNA MD NPI 1265427108

NPI Information

NPI: 1265427108
Provider Name: MARY BETH MADONNA, MD
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
333 N SANTA ROSA
SAN ANTONIO, TX
ZIP 78207
Phone: (210) 704-4100
Get Directions

Mary Beth Madonna, MD is a pediatric surgery surgery in San Antonio, TX. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Mary Beth Madonna, MD NPI is 1265427108. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

333 N SANTA ROSA
SAN ANTONIO, TX
ZIP 78207-108
Phone: (210) 704-4100

The NPI 1265427108 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/16/2005 and was last updated on 11/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	036-083049	ILLINOIS	No
2	2086S0120X	Surgery	Pediatric Surgery	U0254	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036083049	MEDICAID	ILLINOIS
2	1627123	OTHER	ILLINOIS	BCBS PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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