Individual provider Active NPI

Brandy D Wellmon, MS

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1710903778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04437 Issued in TX
Practice address
6500 North Mopac
BLDG. III Suite 200
Austin, TX 78731
Phone
(512) 458-8400
Fax
(512) 458-8593
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA04437 TX Primary

Addresses

Primary practice location

6500 North Mopac
BLDG. III Suite 200
Austin, TX 78731

Mailing address

6500 North Mopac
BLDG. III Suite 200
Austin, TX 78731
Phone (512) 458-8400

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
I20070226000124 TX Practitioner - Physician Assistant 6709988579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6500 N Mopac Expressway
BLDG 3 Suite 200
Austin, TX 78731-4309
Phone (512) 458-8400

Merit-based Incentive Payment System (MIPS)

Final score
75.33 of 100Reported as group
Quality
65.64
Promoting interoperability
76
Improvement activities
40
Cost
72.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04437TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Diabetes and Endocrinology PA CurrentSince Aug 21, 2006 Accepting new patients

Locations

6500 N Mopac Expy
Bldg 3
Austin, TX 78731
Phone (512) 458-8400

5000 Davis Ln
Ste 200
Austin, TX 78749
Phone (512) 338-4500

110 Deer Ridge Dr
Round Rock, TX 78681
Phone (512) 458-8400

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710903778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 NORTH MOPAC",
            "address_2": "BLDG. III SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-458-8400",
            "fax_number": "512-458-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 NORTH MOPAC",
            "address_2": "BLDG. III SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-458-8400",
            "fax_number": "512-458-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMON",
        "first_name": "BRANDY",
        "middle_name": "D",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.