KELLY MAEDO (M.D.) – Dermatology Physician, NPI 1104838887
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,284 DERMATOLOGY in TX
Provider Addresses for KELLY MAEDO (M.D.)
2911, Texas Avenue South, College Station, Brazos County, Texas, 77845, United States
SUITE 103
COLLEGE STATION, TX 778455387
Phone: (979) 764-2882
Fax: (979) 764-2828
Type: Mailing
2911 Texas Ave S
Suite 103
College Station, TX 778455387
Phone: (979) 764-2882
Fax: (979) 764-2828
Type: Location
3100 BUDDY OWENS AVE
MCALLEN, TX 785046464
Phone: (956) 971-0404
Fax: (956) 971-0408
Type: Location
818 ROYAL ADELADE DR
COLLEGE STATION, TX 778454444
Phone: (979) 757-1103
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080225000655 | I | Family Practice | TX | TBD |
| I20240501002379 | I | Dermatology | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 17 | 16 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 77845)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| - | TX | |
| Infectious Disease, Dermatology, Internal Medicine | AZ | |
| D E R M A T O L O G Y | PR | |
| Physician Assistant | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | NV | |
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| D E R M A T O L O G Y | WV |
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