Individual provider Active NPI

Kelsi Ann Vilardo, PA-C

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1407367881
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA13776 Issued in TX
Practice address
2204 Austin St Ste 200
Houston, TX 77002-8912
Phone
(713) 640-5477
Fax
(713) 640-5872
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA13776 TX Primary

Addresses

Primary practice location

2204 Austin St Ste 200
Houston, TX 77002-8912

Mailing address

2204 Austin St Ste 200
Houston, TX 77002-8912
Phone (713) 640-5477

Other practice location 1

10907 Memorial Hermann Dr Ste 300
Pearland, TX 77584-4194
Phone (713) 640-5477

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
I20230331000569 TX Practitioner - Physician Assistant 6305194002 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23937/brand/1/csg/1/fhir/r4

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1407367881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 AUSTIN ST STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028912",
            "telephone_number": "713-640-5477",
            "fax_number": "713-640-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 AUSTIN ST STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028912",
            "telephone_number": "713-640-5477",
            "fax_number": "713-640-5872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10907 Memorial Hermann Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775844194",
            "country_code": "US",
            "telephone_number": "713-640-5477",
            "fax_number": "713-640-5872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILARDO",
        "first_name": "KELSI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.