Individual provider Active NPI

Graciela Patricia Spencer, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Seguin, TX
National Provider Identifier
1720011430
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04969 Issued in TX
Practice address
1483 E Court St
Seguin, TX 78155-5165
Phone
(830) 560-2813
Fax
(830) 560-2812
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 PA04969 TX Primary

Addresses

Primary practice location

1483 E Court St
Seguin, TX 78155-5165

Mailing address

1483 E Court St
Seguin, TX 78155-5165
Phone (830) 560-2813

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
I20060731000450 TX Practitioner - Physician Assistant 4880607290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

421 S King St
Wellmed at Seguin
Seguin, TX 78155-5838
Phone (830) 560-2813

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA04969TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Nov 29, 2021 Accepting new patients
Hugo a. Rojas, M.D.,P.a. Past Accepting new patients

Locations

12702 Toepperwein Rd
Ste 120
Live Oak, TX 78233
Phone (210) 637-5742

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

7323 Marbach Rd
Ste 104
San Antonio, TX 78227
Phone (210) 674-0257

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

1483 E Court St
Seguin, TX 78155
Phone (830) 560-2813

421 S King St
Seguin, TX 78155

Interoperability endpoints

  • Direct secure messaging: graciela.spencer@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1720011430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555165",
            "telephone_number": "830-560-2813",
            "fax_number": "830-560-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555165",
            "telephone_number": "830-560-2813",
            "fax_number": "830-560-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "GRACIELA",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.