DR. MADONNA M MAMEROW PHD, RDN, LD
NPI 1104488220
Dietitian, Registered in League City, TX

Q: What is Madonna Mamerow's NPI number?

The NPI number for Madonna Mamerow is 1104488220. It was assigned to this individual provider in the NPPES registry on June 28, 2019. The provider is also known as Dr. Donna M Victor Phd, Rd, Ld.

Q: What is Madonna Mamerow's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Madonna Mamerow was last updated on September 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2019Accepts Medicare Assignment

2600 S SHORE BLVD STE 300, LEAGUE CITY, TX 77573(281) 436-9668(833) 259-9548 Get Directions Write a Review

NPPES record last updated: September 3, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 3, 2022, May 20, 2022, May 26, 2020 and 1 more (4 updates tracked since 2020).

On this page

About Dr. Madonna M Mamerow Phd, Rdn, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MADONNA M MAMEROW PHD, RDN, LD (NPI 1104488220) is an individual dietitian, registered in League City, Texas, licensed in Texas (DT86015) and active in the NPI registry since June 2019. She is a graduate of Other (2008).

NPPES Registry Identity

NPI1104488220

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameDR. MADONNA M MAMEROWCredential: PHD, RDN, LD

Location Address2600 S SHORE BLVD STE 300League City, TX 77573-2944

Mailing AddressPo Box 433Galveston, TX 77553-0433 · (281) 436-9668 · Fax (833) 259-9548

Phone(281) 436-9668

Fax(833) 259-9548

Sole ProprietorYes

Medical School CMSOtherGraduated 2008

Enumeration DateJune 28, 2019

Last NPPES UpdateSeptember 3, 20224 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2022

✔ NPI 1104488220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in TX · DT86015

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

2600 S SHORE BLVD STE 300, League City, TX 77573

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Other Names 1

Professional Name (2)Dr. Donna M Victor Phd, Rd, Ld

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Madonna M Mamerow Phd, Rdn, Ld is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466886833

PECOS Enrollment IDI20191218002775

Medicare Billing Reassignment

Medicare enrollment records show Madonna Mamerow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Victor Nutrition, LLC

Same address

Dietitian, Registered

2600 S SHORE BLVD STE 300
League City, TX 77573

Reassigned Medicare billing, Texas enrollment

NPI 1023654670 (281) 436-9668

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77573 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $57.19 – $173.07

Typical copayment $0.00 (range $14.29 – $43.26)

Most-billed visit code NA

Established Patient

$100.90 typical visit price

range $18.45 – $141.36

Typical copayment $25.22 (range $4.61 – $35.34)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICTOR NUTRITION, LLC

Dietitian, Registered