Individual provider Active NPI

Alyssa L Ellerbrock, MD

  • Family Medicine Physician
  • Spring, TX
National Provider Identifier
1326629049
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U2478 Issued in TX
Practice address
8000 Research Forest Dr Ste 360
Spring, TX 77382-1559
Phone
(281) 292-1191
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10074828 TX
Family Medicine Physician 207Q00000X U2478 TX Primary

Addresses

Primary practice location

8000 Research Forest Dr Ste 360
Spring, TX 77382-1559

Mailing address

8000 Research Forest Dr Ste 360
Spring, TX 77382-1559
Phone (281) 292-1191

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
I20240910004837 TX Practitioner - Family Practice 8729487939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas at Austin Dell Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

17510 W Grand Pkwy S
Sugar Land, TX 77479-2649

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

8000 Research Forest Dr
Suite 360
The Woodlands, TX 77382-1559
Phone (281) 292-1192

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast PLLC CurrentSince Jul 27, 2024 Accepting new patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Jul 27, 2024 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

8000 Research Forest Dr
Ste 360
The Woodlands, TX 77382
Phone (281) 292-1191

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.

Hospital & facility affiliations 6

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1326629049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 RESEARCH FOREST DR STE 360",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773821559",
            "telephone_number": "281-292-1191",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 RESEARCH FOREST DR STE 360",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773821559",
            "telephone_number": "281-292-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBROCK",
        "first_name": "ALYSSA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10074828",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U2478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.