Individual provider Active NPI

Kayla Lezak, PA-C

  • Physician Assistant
  • Wharton, TX
National Provider Identifier
1700288552
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1041 US 59 Highway Suite a
Wharton, TX 77488
Phone
(979) 245-2008
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 Primary

Addresses

Primary practice location

1041 US 59 Highway Suite a
Wharton, TX 77488

Mailing address

1722 County Road 424
El Campo, TX 77437-7158
Phone (979) 541-9932

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
I20160601001298 TX Practitioner - Physician Assistant 7214259746 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matagorda Episcopal Health Outreach Program Corporation CurrentSince Sep 1, 2018 Accepting new patients
Nluc PLLC CurrentSince Sep 1, 2022 Accepting new patients
Matagorda Episcopal Health Outreach Program CurrentSince Sep 1, 2018 Accepting new patients
Next Level MV LLC Current Accepting new patients
El Campo Memorial Hospital CurrentSince Apr 23, 2016 Accepting new patients
El Campo Memorial Hospital CurrentSince Apr 23, 2016 Accepting new patients
Memeeha, LLC Past Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients

Locations

111 Avenue F
Bay City, TX 77414
Phone 9792452008300

7710 Garth Rd
Ste A
Baytown, TX 77521

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

307 Green Ave
Ste A
Palacios, TX 77465
Phone 9792452008300

8325 Broadway St
Ste 220
Pearland, TX 77581
Phone (281) 873-8162

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

2112 Regional Medical Dr
Ste 1313
Wharton, TX 77488
Phone 9792452008300

10119 US 59 Hwy
Wharton, TX 77488
Phone 9792452008302

2112 Regional Medical Dr
Ste 1317
Wharton, TX 77488
Phone 9792452008300

2112 Regional Medical Dr
Ste 1315
Wharton, TX 77488
Phone 9792452008300

Interoperability endpoints

  • Direct secure messaging: kayla.lezak.1@17406.direct.athenahealth.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1700288552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 COUNTY ROAD 424",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774377158",
            "telephone_number": "979-541-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 US 59 HIGHWAY SUITE A",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "77488",
            "telephone_number": "979-245-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZAK",
        "first_name": "KAYLA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wharton, TX

Sources for this page

Verify at the official NPI Registry.