Individual provider Active NPI

Laura Pacek, P.A.

  • Physician Assistant
  • Yorktown, TX
National Provider Identifier
1437193943
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01213 Issued in TX
Practice address
508 N Riedel St
Yorktown, TX 78164-1810
Phone
(361) 564-9230
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 PA01213 TX Primary

Addresses

Primary practice location

508 N Riedel St
Yorktown, TX 78164-1810

Mailing address

508 N Riedel St
Yorktown, TX 78164-1810
Phone (361) 564-9230

Other identifiers 3

IdentifierTypeStateIssuer
PA01213OtherTXPA LIC
285135404MedicaidTX
346885YK7YOtherTXMEDICARE PTAN

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
I20140603001229 TX Practitioner - Physician Assistant 4385603505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dewitt Medical DistrictGroup PAC ID 3072421395, 32 clinicians

Practice addresses (Care Compare)

113 W Main St
Kenedy, TX 78119-2717
Phone (830) 583-0612

139 W Franklin St
Goliad, TX 77963-4281
Phone (361) 645-8235

2500 N Esplanade St
Cuero, TX 77954-4723

2500 N Esplanade St
Cuero, TX 77954-4727
Phone (361) 275-3466

508 N Riedel St
Yorktown, TX 78164-1810
Phone (361) 564-9230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01213TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dewitt Medical District CurrentSince Mar 12, 2014 Accepting new patients
Dewitt Medical District CurrentSince Mar 12, 2014 Accepting new patients
Dewitt Medical District Past Accepting new patients

Locations

2500 N Esplanade St
Ste 101
Cuero, TX 77954
Phone (361) 275-2381

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

113 W Main St
Kenedy, TX 78119
Phone (830) 583-0612

508 N Riedel St
Yorktown, TX 78164
Phone (361) 564-3383

670 W 4th St
Yorktown, TX 78164
Phone (361) 564-2275

Interoperability endpoints

  • Direct secure messaging: laurapacek@dmdclinic.allscriptsdirect.net

Organizations & group practices 5

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 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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1437193943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N RIEDEL ST",
            "city": "YORKTOWN",
            "state": "TX",
            "postal_code": "781641810",
            "telephone_number": "361-564-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N RIEDEL ST",
            "city": "YORKTOWN",
            "state": "TX",
            "postal_code": "781641810",
            "telephone_number": "361-564-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACEK",
        "first_name": "LAURA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LIC",
            "identifier": "PA01213",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285135404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "346885YK7Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, TX

Sources for this page

Verify at the official NPI Registry.