Individual provider Active NPI

Lelve Justin Gayle, MD

  • Obstetrics & Gynecology Physician
  • College Station, TX
National Provider Identifier
1285632737
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J6453 Issued in TX
Practice address
1602 Rock Prairie Rd Ste 460
College Station, TX 77845-8309
Phone
(979) 704-6173
Fax
(979) 704-6174
NPI assigned
Jul 8, 2005
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X J6453 TX Primary

Addresses

Primary practice location

1602 Rock Prairie Rd Ste 460
College Station, TX 77845-8309

Mailing address

1602 Rock Prairie Rd Ste 460
College Station, TX 77845-8309
Phone (979) 704-6173

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000970 TX Practitioner - Obstetrics/Gynecology 1557558541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1602 Rock Prairie Rd
Suite 460
College Station, TX 77845-8309
Phone (979) 704-6173

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
L Justin Gayle MD PLLC Obstetrics & Gynecology CurrentSince Jan 27, 2015 Accepting new patients
Regional Employee Assistance Program Inc Obstetrics & Gynecology Past Accepting new patients
Scott & White Hospital - College Station Past Accepting new patients
St Joseph Regional Health Center Past Accepting new patients

Locations

3201 University Dr E
Ste 370
Bryan, TX 77802
Phone (979) 703-1426

Interoperability endpoints

  • Direct secure messaging: gaylel@yourcarecommunity.org

Organizations & group practices 4

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 2

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1285632737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 460",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458309",
            "telephone_number": "979-704-6173",
            "fax_number": "979-704-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD STE 460",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458309",
            "telephone_number": "979-704-6173",
            "fax_number": "979-704-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLE",
        "first_name": "LELVE",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J6453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.