Individual provider Active NPI

Lizeth Becerra, PA

  • Physician Assistant
  • Brownsville, TX
National Provider Identifier
1437565959
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09091 Issued in TX
Practice address
5460 Paredes Line Rd
Ste 200
Brownsville, TX 78526-9740
Phone
(956) 554-0010
Fax
(956) 554-3288
NPI assigned
Jul 3, 2014
Last updated
Mar 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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 PA09091 TX Primary

Addresses

Primary practice location

5460 Paredes Line Rd
Ste 200
Brownsville, TX 78526-9740

Mailing address

5460 Paredes Line Rd
Ste 200
Brownsville, TX 78526-9740
Phone (956) 554-0010

Other identifiers 2

IdentifierTypeStateIssuer
426488YLPSOtherTXWELLMED PTAN
352145201MedicaidTX

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
I20150810000714 TX Practitioner - Physician Assistant 3779897459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

801 S Main St
Suite C
McAllen, TX 78501-5056
Phone (956) 686-0574

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jun 1, 2015 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Jun 1, 2015 Accepting new patients

Locations

5460 Paredes Line Rd
Ste 200
Brownsville, TX 78526
Phone (956) 554-0010

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: lizeth.becerra@wellmed.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1437565959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 PAREDES LINE RD",
            "address_2": "STE 200",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785269740",
            "telephone_number": "956-554-0010",
            "fax_number": "956-554-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 PAREDES LINE RD",
            "address_2": "STE 200",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785269740",
            "telephone_number": "956-554-0010",
            "fax_number": "956-554-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "LIZETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "426488YLPS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352145201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.