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MARCENE R. MCVAY GILLAM MD
NPI 1962627984
Surgery - Pediatric Surgery in San Antonio, TX

Active since April 16, 2007PECOS Enrolled
4502 MEDICAL DR, SAN ANTONIO, TX 78229(210) 358-4000(210) 358-4775 Get Directions Write a Review

NPPES record last updated: October 18, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 3, 2024, Jul 29, 2024, Dec 7, 2023 and 1 more (4 updates tracked since 2017).

About Marcene R. Mcvay Gillam Md NPPES

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

MARCENE R. MCVAY GILLAM MD (NPI 1962627984) is an individual pediatric surgery provider in San Antonio, Texas, licensed in Texas (P3650) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1962627984
Entity TypeIndividualFemale
Primary Taxonomy2086S0120X
Provider Legal NameMARCENE R. MCVAY GILLAMCredential: MD
Location Address4502 MEDICAL DRSan Antonio, TX 78229-4402
Mailing AddressPo Box 6908Springdale, AR 72766-6908 · (501) 349-3182
Phone(210) 358-4000
Fax(210) 358-4775
Sole ProprietorNo
Enumeration DateApril 16, 2007
Last NPPES UpdateOctober 18, 20244 updates tracked since enumeration
NPPES CertifiedOctober 18, 2024
✔ NPI 1962627984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Licenses✔ Licensed in TX · P3650✔ Licensed in OK · 42264✔ Licensed in AR · E-4933
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedSurgeryTaxonomy 208600000X · License P3650 (TX), E-4933 (AR)
4502 MEDICAL DR, San Antonio, TX 78229
Open in Google Maps ↗

Other Names 1

Former Name (1)Marcene Renee Mcvay Md

Secondary Practice Locations 2

Location 16151 S Yale Ave Ste 1305Tulsa, OK 74136-1907 · Phone (918) 494-9450 · Fax (918) 494-9437
Location 23623 Johnson Mill Blvd Ste 101Springdale, AR 72762-6412 · Phone (479) 222-0190 · Fax (800) 730-1097

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marcene R. Mcvay Gillam 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.

Medicare Billing Reassignments

4

Medicare enrollment records show Marcene Mcvay Gillam reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Medicine Associates
7.0 mi
Family Medicine
903 W MARTIN ST # MS 49-2
San Antonio, TX 78207
  • Reassigned Medicare billing, Texas enrollment
  • 1,129 clinicians in this Medicare group
NPI 1245313329 (210) 358-3401
Warren Clinics Inc
409 mi
Medical Specialty
1401 E VAN BUREN AVE
Mcalester, OK 74501
  • Reassigned Medicare billing, Oklahoma enrollment
  • Medicare enrollment name: Warren Clinic Inc
  • 1,144 clinicians in this Medicare group
NPI 1649204074 (918) 426-0240
University Of Arkansas For Medical Sciences
509 mi
Adolescent Medicine
9015 DAILEY DR
Little Rock, AR 72209
  • Reassigned Medicare billing, Arkansas enrollment
  • 1,246 clinicians in this Medicare group
NPI 1285307744 (501) 364-6560
Arkansas Childrens Hospital
517 mi
Pediatrics
1 CHILDRENS WAY # 664
Little Rock, AR 72202
  • Reassigned Medicare billing, Arkansas enrollment
  • 944 clinicians in this Medicare group
NPI 1598773079 (501) 364-2526

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

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.

EDUARDO N. POLLONO MD
Internal Medicine (Cardiovascular Disease)
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000
DR. MAHDIEH IRAN NEJAD PARIZI M.D.
Student in an Organized Health Care Education/Training Program
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-2015
RICHARD LEE BALLENTINE D.M.D.
Student in an Organized Health Care Education/Training Program
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-2015
MR. STEVAN REYES PTA
Physical Therapy Assistant
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4253
MRS. CLAIRE LELEUX BEADLE CRNA
Nurse Anesthetist, Certified Registered
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000
NNENNA AWAGU CRNA
Nurse Anesthetist, Certified Registered
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 567-4500
DR. CYNTHIA N NGUYEN PHARMD
Pharmacist
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 743-4034
DR. JONATHAN EDWARD SLOVIK MD
Hospitalist
4502 MEDICAL DR
SAN ANTONIO, TX 78229
Bexar County (210) 358-4000

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 Marcene Mcvay Gillam's NPI number?

The NPI number for Marcene Mcvay Gillam is 1962627984. It was assigned to this individual provider in the NPPES registry on April 16, 2007. The provider is also known as Marcene Renee Mcvay MD.

Where is Marcene Mcvay Gillam located?

Marcene Mcvay Gillam practices at 4502 Medical Dr, San Antonio, TX 78229. The listed phone number is (210) 358-4000.

What is Marcene Mcvay Gillam's specialty?

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

Is Marcene Mcvay Gillam enrolled in Medicare?

Yes. Marcene Mcvay Gillam is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Marcene Mcvay Gillam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marcene Mcvay Gillam reassigns Medicare benefits to 4 organizations: Community Medicine Associates (San Antonio, TX), Warren Clinics Inc (Mcalester, OK), University Of Arkansas For Medical Sciences (Little Rock, AR) and Arkansas Childrens Hospital (Little Rock, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marcene Mcvay Gillam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marcene Mcvay Gillam accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 12 other insurers list Marcene Mcvay Gillam 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.

When was this NPI record last updated?

The NPPES record for Marcene Mcvay Gillam was last updated on October 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.