Alissa G Huberty, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-639 Issued in AR

Practice address

4301 W Markham St # 610
Little Rock, AR 72205-7101

Phone

(501) 526-6551

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alissa G Blackwell Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Medical Group PLLCGroup PAC ID 1153753520, 17 clinicians

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahuberty@pmg.emadirect.md

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.

• Prime Medical Group PLLC

  • Dermatology Physician
  • Little Rock, AR
  • NPI 1427605153
  Medicare reassignment Care Compare group
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment Care Compare group
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Optometrist
  • Little Rock, AR
  • NPI 1275917809
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Arkansas for Medical Sciences

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1477549756
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1366801995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 PROSPECT TRL",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 610",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERTY",
        "first_name": "ALISSA",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISSA",
            "last_name": "BLACKWELL",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Candra Danielle Hubbard, PHARMD
• Hannah Hubbard
• Termeka Hubbard
• Jesse Doyle Hubberd, LCSW
• Michael David Huber, MD
• Mary Huckabee, MD
• Urooj Hudda
• Ashley Huddleston, MSW
• Ammar Matthew Hudefi
• Bailey Hudelson

• Physician Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.