Active NPI
Lacey N Graffagnino, LSA
- Surgical Assistant
- Beaumont, TX
National Provider Identifier
1669710448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- SA00911
- Practice address
- 9325 Phelan Blvd
Beaumont, TX 77706-5122 - Phone
- (214) 227-2457
- Fax
- (214) 764-0880
- NPI assigned
- Jan 29, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 149840 | TX | |
| Surgical Assistant | 246ZC0007X | 210590 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgical Assistant | 246ZC0007X | SA00911 | TX | Primary |
Addresses
Primary practice location
9325 Phelan Blvd
Beaumont, TX 77706-5122
Mailing address
PO Box 2550
Rowlett, TX 75030-2550
Phone (214) 227-2457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210590 | GA | MD | Surgical Assistant |
| 149840 | TX | MD | Surgical Assistant |
| SA00911 | TX | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Surgical Associates LLC | Surgical Assistant | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgical Assistant
- Beaumont, TX
- NPI 1093473183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1669710448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2550",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750302550",
"telephone_number": "214-227-2457",
"fax_number": "214-764-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9325 PHELAN BLVD",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777065122",
"telephone_number": "214-227-2457",
"fax_number": "214-764-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAFFAGNINO",
"first_name": "LACEY",
"middle_name": "N",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "149840",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "GA",
"license": "210590",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "SA00911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaumont, TX
- Grace Healthcare Staffing Agency
- Connie R Gradney, LBSW
- Dominic Joseph Gradozzi III
- Brianna Lee Graffagnino, LMT
- Jordan Brett Graffagnino, LSA, CSFA
- Clancie Calais Grant, RPH
- Shawn Rooney Gray, MSN
- Great American Scooter Company Golden Triangle LLC
- Greater Beaumont Oral & Maxillofacial Surgery, PA
- Greater Houston Emergency Physicians PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.