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ADARSH MAMACHEN M.D.
NPI 1881121622
Hospitalist in Edinburg, TX

Active since May 11, 2017PECOS EnrolledAccepts Medicare Assignment
1401 MALTESE ST, EDINBURG, TX 78539(956) 280-2580 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 19, 2024, Jun 29, 2020, May 11, 2017 (3 updates tracked since 2017).

About Adarsh Mamachen M.d. NPPES

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

ADARSH MAMACHEN M.D. (NPI 1881121622) is an individual hospitalist provider in Edinburg, Texas, licensed in Texas (S7719) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2017).

NPPES Registry Identity

NPI1881121622
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameADARSH MAMACHENCredential: M.D.
Location Address1401 MALTESE STEdinburg, TX 78539-3442
Mailing Address1401 Maltese StEdinburg, TX 78539-3442 · (956) 280-2580
Phone(956) 280-2580
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2017
Enumeration DateMay 11, 2017
Last NPPES UpdateSeptember 19, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2024
✔ NPI 1881121622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in TX · S7719
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License BP10060874 (TX)
1401 MALTESE ST, Edinburg, TX 78539
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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 and accepts Medicare assignment

Adarsh Mamachen M.d. 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 ID9638597735
PECOS Enrollment IDI20200921003134
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
57 services55 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
51 services50 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450128
Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County
Emergency services Birthing friendly

Harlingen Medical Center

Acute Care Hospitals · Harlingen, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450855
Location5501 South Expressway 77Harlingen, TX 78550 · Cameron County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adarsh Mamachen's NPI number?

The NPI number for Adarsh Mamachen is 1881121622. It was assigned to this individual provider in the NPPES registry on May 11, 2017.

Where is Adarsh Mamachen located?

Adarsh Mamachen practices at 1401 Maltese St, Edinburg, TX 78539. The listed phone number is (956) 280-2580.

What is Adarsh Mamachen's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Adarsh Mamachen enrolled in Medicare?

Yes. Adarsh Mamachen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Adarsh Mamachen accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Adarsh Mamachen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Adarsh Mamachen affiliated with any hospitals?

According to CMS data, Adarsh Mamachen is affiliated with South Texas Health System, Knapp Medical Center and Harlingen Medical Center.

When was this NPI record last updated?

The NPPES record for Adarsh Mamachen was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.