NPIMap

Individual provider Active NPI

Donna Lynn Gilliam, PA-C

  • Physician Assistant
  • New Braunfels, TX
National Provider Identifier
1083726459
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03687 Issued in TX
Practice address
1761 Highway 46 W Ste 104
New Braunfels, TX 78132-4750
Phone
(830) 608-1575
Fax
(830) 608-0868
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03687 TX Primary

Addresses

Primary practice location

1761 Highway 46 W Ste 104
New Braunfels, TX 78132-4750

Mailing address

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 303-9400

Other identifiers 3

IdentifierTypeStateIssuer
H0143584OtherTXDPS
PA03687OtherTXLICENSE
218278401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000404 TX Practitioner - Physician Assistant 2769544147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guadalupe County Hospital BoardGroup PAC ID 5496653842, 31 clinicians

Practice addresses (Care Compare)

1215 E Court
HBP Cardiology Group
Seguin, TX 78155-5129
Phone (830) 379-2411

1215 E Court St
Seguin, TX 78155-5129
Phone (830) 379-2411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Guadalupe County Hospital Board Current Accepting new patients
Guadalupe Regional Medical Group CurrentSince Nov 15, 2020 Accepting new patients
Guadalupe County Hospital Board CurrentSince Jul 24, 2018 Accepting new patients
Guadalupe County Hospital Board CurrentSince Jul 24, 2018 Accepting new patients
Guadalupe County Hospital Board Current Accepting new patients
Hugo a. Rojas, M.D.,P.a. Past Accepting new patients
Guadalupe County Hospital Board Past Accepting new patients

Locations

1761 State Highway 46 S
Ste 104
New Braunfels, TX 78130
Phone (830) 401-7558

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

1350 Ashby St
Seguin, TX 78155
Phone (830) 303-9400

Interoperability endpoints

  • Direct secure messaging: gildo@direct.grmedcenter.com
  • FHIR API: https://api.platform.athenahealth.com/27064/brand/1/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083726459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-303-9400",
            "fax_number": "830-303-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 HIGHWAY 46 W STE 104",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781324750",
            "telephone_number": "830-608-1575",
            "fax_number": "830-608-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "H0143584",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA03687",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218278401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.