Individual provider Active NPI

Allyssa Marie Cantu, PA-C

  • Physician Assistant
  • Mission, TX
National Provider Identifier
1285131995
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11930 Issued in TX
Practice address
2506 E Griffin Pkwy
Mission, TX 78572-3348
Phone
(956) 600-7807
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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 PA11930 TX Primary

Addresses

Primary practice location

2506 E Griffin Pkwy
Mission, TX 78572-3348

Mailing address

2506 E Griffin Pkwy
Mission, TX 78572-3348
Phone (956) 600-7807

Other practice location 1

417 Tanglewood Dr
Mission, TX 78574-2323
Phone (956) 432-9855

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
I20180711003377 TX Practitioner - Physician Assistant 4284980822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JNC Behavioral Services, P.a.Group PAC ID 9931379245, 7 clinicians

Practice addresses (Care Compare)

345 Lorenaly Dr
Brownsville, TX 78526-4333
Phone (956) 545-0646

609 N Jackson Rd
Edinburg, TX 78541-2851
Phone (956) 600-7807

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA11930TXMDPhysician Assistant

Organizations & group practices 1

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1285131995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 E GRIFFIN PKWY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723348",
            "telephone_number": "956-600-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 E GRIFFIN PKWY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723348",
            "telephone_number": "956-600-7807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 Tanglewood Dr",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "785742323",
            "country_code": "US",
            "telephone_number": "956-432-9855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTU",
        "first_name": "ALLYSSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.