Vivianna Jaclynn Chapa, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17180 Issued in TX

Practice address

1010 S Ponds Dr
Webster, TX 77598-1409

Phone

(713) 442-4300

NPI assigned

Sep 28, 2023

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

• Vivianna Jaclynn Cavazos Former name

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

Specialty

Physician Assistant

Education

University of Texas Medical Branch at Galveston, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: vchapa69249@direct.kelsey-seybold.com

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.

• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255
  Medicare reassignment Care Compare group
• KS SC LLC

  • Ambulatory Surgical Clinic/Center
  • Webster, TX
  • NPI 1700648037
  NPD (past)

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1487433397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S PONDS DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775981409",
            "telephone_number": "713-442-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPA",
        "first_name": "VIVIANNA",
        "middle_name": "JACLYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIANNA",
            "last_name": "CAVAZOS",
            "middle_name": "JACLYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Champagne, FNP-C
• Siddardha Chandrupatla, DDS MMSC
• Katisha Chaney
• Charlie Chih Lee Chang, M.D.
• Janice R. Chang, M.D.
• Chau M Vu M D P a
• Chau M Vu MD PA
• Jenny Chau, OTR
• Gita Chaudhari
• Hannan Chaugle, M.D.

• Physician Assistant in Webster, TX
• Providers in Webster, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.