Individual provider Active NPI

Kylie Listi, PA-C

  • Physician Assistant
  • The Woodlands, TX
National Provider Identifier
1235846163
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17580 Interstate 45 S
The Woodlands, TX 77384-4972
Phone
(832) 822-3180
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 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

17580 Interstate 45 S
The Woodlands, TX 77384-4972

Mailing address

17580 Interstate 45 S FL 3
The Woodlands, TX 77384-4972

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
I20230302001267 TX Practitioner - Physician Assistant 9830562479 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 Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

101 W Expressway
Suite 83
McAllen, TX 78503-1341
Phone (956) 661-9840

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Angela M. Davis, M.D.P.a. PastSince Nov 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mxyzstudent304723@prddirect.texaschildrens.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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1235846163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17580 INTERSTATE 45 S FL 3",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17580 INTERSTATE 45 S",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844972",
            "telephone_number": "832-822-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTI",
        "first_name": "KYLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.