Clarissa Syvonne Elizondo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13169 Issued in TX

Practice address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Phone

(806) 744-7223

Fax

(806) 740-3325

NPI assigned

May 13, 2019

Last updated

Dec 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Tech University Health Sciences Center Lubbock

  dba TTUHSC/Anatomical Pathology

  • Anatomic Pathology Physician
  • Lubbock, TX
  • NPI 1063461358
  Medicare reassignment
• Texas Tech University Health Sciences Center Lubbock

  dba Ttuhsc - DME

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
  • NPI 1053458026
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Pediatrics Physician
  • Lubbock, TX
  • NPI 1972552263
  NPD
• Texas Tech University Health Sciences Center Lubbock

  dba TTUHSC - Anesthesiology

  • Anesthesiology Physician
  • Lubbock, TX
  • NPI 1306894175
  NPD (past)

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1740846955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5618 116th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794247778",
            "country_code": "US",
            "telephone_number": "806-441-4694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "CLARISSA",
        "middle_name": "SYVONNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celizondo1379993@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nadia Eleda, NP
• Emadeldeen M Ahmed Elgwairi, MD
• Elias Ghandour, MD, PA
• Eliot Dennard PHD
• Elite Primary Care and Wellness, PLLC
• Jacqueline Ann Elizondo, LAT, OTC, ROT, OPE-C
• Jose E Elizondo, PAC
• Joshua Eric Elizondo, PTA
• Pamela J. Elkins, NP
• Karsen Elliot

• Physician Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.