Alexandra Leggett Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12908 Issued in TX

Practice address

1700 Post Oak Blvd Ste 11501160
Houston, TX 77056-3963

Phone

(888) 663-6331

NPI assigned

Nov 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Alexandra Elizabeth Leggett Former name

Medicare fee-for-service enrollment

Enrolled in DC, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

TMH Physician OrganizationGroup PAC ID 4880670108, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• TMH Physician Organization

  • Vascular Surgery Physician
  • Houston, TX
  • NPI 1235183096

  TX

  Medicare reassignment Care Compare group NPD
• One Medstar Primary Care LLC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1417571530

  DC

  Medicare reassignment
• TMH Physician Organization

  • Family Medicine Physician
  • Houston, TX
  • NPI 1831862291
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1649815341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 POST OAK BLVD STE 11501160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563963",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 POST OAK BLVD STE 11501160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563963",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Connecticut Ave Ph Suite",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208155822",
            "country_code": "US",
            "telephone_number": "202-660-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10215 Fernwood Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208171183",
            "country_code": "US",
            "telephone_number": "301-493-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Tysons Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221024285",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ALEXANDRA",
        "middle_name": "LEGGETT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07428",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA12908",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DEPARTMENT OF HEALTH BOARD OF PHYSICIANS",
            "identifier": "C0007428",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "LEGGETT",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Bourgeois M.D.
• Kelly T.L. Tran, O.D., P.a.
• Kelly Zhao PLLC
• Sonya Kelly-Mothershed
• Vionna Kelly-Simeus, CSA
• Alison Barbara Kelly, MOT, OTR/L
• Alyssa J Kelly, M.A., CCC-SLP
• Amy Christine Kelly, NP-C
• Aneisha Lichelle Kelly
• Anthony Kelly

• All providers in Houston, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.