NPIMap

Individual provider Active NPI

Stacia Hookom Gollihar, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1265741508
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06976 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4009
Phone
(713) 792-6161
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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 PA06976 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4009

Mailing address

PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other identifiers 2

IdentifierTypeStateIssuer
832N58OtherTXBCBS
220488501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230829003847 NM Practitioner - Physician Assistant 8729273495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

2990 Rodeo Park Dr E
Santa Fe, NM 87505-6302
Phone (505) 913-8900

433 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 988-1232

445 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-8900

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Hospital & facility affiliations

  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
  • Holy Cross Hospital a Div of Taos Health Systems Hospital, Taos, NM, CCN 321310

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Aug 14, 2023 Accepting new patients
St Vincent Hospital Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
St. Vincent Hospital Past Accepting new patients

Locations

2237 Trinity Dr
Ste B
Los Alamos, NM 87544
Phone (505) 662-8870

445 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-8900

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

455 Saint Michaels Dr
#A
Santa Fe, NM 87505

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

2990 Rodeo Park Dr E
Santa Fe, NM 87505
Phone (505) 428-5400

Interoperability endpoints

  • Direct secure messaging: sgollihar334340@christushealth.direct-ci.net

Organizations & group practices 11

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 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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1265741508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304009",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLIHAR",
        "first_name": "STACIA",
        "middle_name": "HOOKOM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "832N58",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220488501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.