Alyssa Nicole Fanella, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

489 Agnes St Ste 100
Bastrop, TX 78602-2157

Phone

(512) 321-9091

NPI assigned

May 25, 2026

Last updated

May 25, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1779667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1619808268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 AGNES ST STE 100",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786022157",
            "telephone_number": "512-321-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 AGNES ST STE 100",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786022157",
            "telephone_number": "512-321-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLA",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-25",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Esteban, O.D.
• Jeffrey Evans, LPC
• Eve Barton, M.Ed., LPC, LLC
• Omolara M Fadare, DDS
• Family Health Center of Bastrop PLLC
• Susan Lynn Farris, LCSW
• Fast Track Urgent Care (Fast Aid Urgent Care)
• Fast Track Urgent Care - Bastrop (Fast Aid Urgent Care - Bastrop)
• Nada Amr Fawzi, DDS
• Fayette Medical Supply, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.