MARY BETH MADONNA MD
NPI 1265427108
Surgery - Pediatric Surgery in San Antonio, TX

Q: What is Mary Beth Madonna's NPI number?

The NPI number for Mary Beth Madonna is 1265427108. It was assigned to this individual provider in the NPPES registry on September 16, 2005.

Q: What is Mary Beth Madonna's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Q: When was this NPI record last updated?

The NPPES record for Mary Beth Madonna was last updated on November 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 September 16, 2005PECOS Enrolled

333 N SANTA ROSA, SAN ANTONIO, TX 78207(210) 704-4100 Get Directions Write a Review

NPPES record last updated: November 16, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 16, 2022, Apr 1, 2021 (2 updates tracked since 2021).

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About Mary Beth Madonna Md NPPES

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

MARY BETH MADONNA MD (NPI 1265427108) is an individual pediatric surgery provider in San Antonio, Texas, licensed in Texas (U0254) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265427108

Entity TypeIndividualFemale

Primary Taxonomy2086S0120X

Provider Legal NameMARY BETH MADONNACredential: MD

Location Address333 N SANTA ROSASan Antonio, TX 78207-3108

Mailing Address333 N Santa RosaSan Antonio, TX 78207-3108 · (210) 704-4100

Phone(210) 704-4100

Sole ProprietorNo

Enumeration DateSeptember 16, 2005

Last NPPES UpdateNovember 16, 20222 updates tracked since enumeration

NPPES CertifiedNovember 16, 2022

✔ NPI 1265427108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

Licenses✔ Licensed in TX · U0254✔ Licensed in IL · 036-083049

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

333 N SANTA ROSA, San Antonio, TX 78207

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Other Identifiers 2

Medicaid036083049IL

Other1627123IL · Bcbs Provider Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Beth Madonna Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

LATHA PRASANNAN MD

Pediatrics (Pediatric Hematology-Oncology)