Individual provider Active NPI

Deanne L Veselka, MD

  • Family Medicine Physician
  • College Station, TX
National Provider Identifier
1144219312
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L5168 Issued in TX
Practice address
4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 690-4460
Fax
(979) 690-4461
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L5168 TX Primary
Family Medicine Physician 207Q00000X 41351 CO

Addresses

Primary practice location

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone (979) 690-4828

Other identifiers 2

IdentifierTypeStateIssuer
55607225MedicaidCO
1144219312MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230919000165 TX Practitioner - Family Practice 3779618871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

4421 State Hwy 6 S
Suite 100
College Station, TX 77845-6176
Phone (979) 690-4460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Regional Health Center CurrentSince Oct 30, 2023 Accepting new patients
St. Joseph Regional Health Center Family Medicine CurrentSince Oct 30, 2023 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 1, 2015 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 1, 2015 Accepting new patients
Optumcare Colorado Medical Group LLC Family Medicine Past Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

6340 Barnes Rd
Colorado Springs, CO 80922
Phone (719) 570-0640

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

5115 Fontaine Blvd
Ste 101
Fountain, CO 80817
Phone (719) 392-2000

5115 Fontaine Blvd
Fountain, CO 80817
Phone (719) 392-2000

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

4421 State Highway 6 S
Ste 100
College Station, TX 77845
Phone (979) 731-5200

Organizations & group practices 6

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

Hospital & facility affiliations 2

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1144219312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4460",
            "fax_number": "979-690-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESELKA",
        "first_name": "DEANNE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5168",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "41351",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55607225",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144219312",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.