Individual provider Active NPI

Paige Kelsey Westmoreland, MBA, PA-C, CAQ-PSYCH

  • Physician Assistant
  • San Angelo, TX
National Provider Identifier
1417519216
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13356 Issued in TX
Practice address
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone
(325) 747-8033
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 PA13356 TX Primary

Addresses

Primary practice location

3555 Knickerbocker Rd
San Angelo, TX 76904-7610

Mailing address

3555 Knickerbocker Rd
San Angelo, TX 76904-7610

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
I20230427003039 TX Practitioner - Physician Assistant 1153786041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 747-1511

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

2626 N Bryant Blvd
San Angelo, TX 76903-2861
Phone (325) 747-1511

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13356TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince May 1, 2023 Accepting new patients

Locations

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

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.

Hospital & facility affiliations 1

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1417519216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-747-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTMORELAND",
        "first_name": "PAIGE",
        "middle_name": "KELSEY",
        "name_prefix": "Miss",
        "credential": "MBA, PA-C, CAQ-PSYCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.