Individual provider Active NPI

Shelly S. Lengefeld, PA

  • Physician Assistant
  • Hamilton, TX
National Provider Identifier
1255562815
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04852 Issued in TX
Practice address
400 N Brown St
BLDG. II
Hamilton, TX 76531-1518
Phone
(254) 386-1700
Fax
(254) 386-4839
NPI assigned
Jul 30, 2009
Last updated
Jul 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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 PA04852 TX Primary

Addresses

Primary practice location

400 N Brown St
BLDG. II
Hamilton, TX 76531-1518

Mailing address

400 N Brown St
BLDG. I
Hamilton, TX 76531-1518
Phone (254) 386-1700

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
I20090915000322 TX Practitioner - Physician Assistant 0840346953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 N Brown St
Hamilton, TX 76531-1518

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton County Hospital District CurrentSince Oct 3, 2016 Accepting new patients
Hamilton County Hospital District CurrentSince Oct 3, 2016 Accepting new patients

Locations

400 N Brown St
Hamilton, TX 76531
Phone (254) 386-1600

400 N Brown St
Bldg I
Hamilton, TX 76531
Phone (254) 386-1600

400 N Brown St
Bldg Ii
Hamilton, TX 76531
Phone (254) 386-1700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1255562815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N BROWN ST",
            "address_2": "BLDG. I",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311518",
            "telephone_number": "254-386-1700",
            "fax_number": "257-386-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BROWN ST",
            "address_2": "BLDG. II",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311518",
            "telephone_number": "254-386-1700",
            "fax_number": "254-386-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENGEFELD",
        "first_name": "SHELLY",
        "middle_name": "S.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, TX

Sources for this page

Verify at the official NPI Registry.