Individual provider Active NPI

Grace Lo

  • Physician Assistant
  • Pasadena, TX
National Provider Identifier
1174286181
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4211 Fairmont Pkwy
Pasadena, TX 77504-3324
Phone
(281) 481-9400
Fax
(281) 481-9490
NPI assigned
Oct 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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 Primary

Addresses

Primary practice location

4211 Fairmont Pkwy
Pasadena, TX 77504-3324

Mailing address

5850 E Still Cir
Mesa, AZ 85206-3618

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230425002328 TX Practitioner - Physician Assistant 1456716596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

18220 State Hwy 249
Suite 290
Houston, TX 77070-4370
Phone (281) 897-8866

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC CurrentSince Apr 1, 2023 Accepting new patients
Texas Digestive Disease Consultants, PLLC Past Accepting new patients

Locations

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

Interoperability endpoints

  • Direct secure messaging: glo468758@direct.stlukeshealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1174286181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043324",
            "telephone_number": "281-481-9400",
            "fax_number": "281-481-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.