Individual provider Active NPI

Shelique Bailey, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1770127995
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115247 Issued in FL
Practice address
6621 Fannin St # a
Houston, TX 77030-2399
Phone
(832) 824-1000
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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 PA9115247 FL Primary

Addresses

Primary practice location

6621 Fannin St # a
Houston, TX 77030-2399

Mailing address

3007 Olinville Ave Apt 3
Bronx, NY 10467-6707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220722000100 FL Practitioner - Physician Assistant 8628459617 Reassigns benefits to 1 organization
I20241120001203 TX Practitioner - Physician Assistant 8628459617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

3195 Dowlen Rd
Suite 105
Beaumont, TX 77706-7272
Phone (409) 860-1888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115247FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Apr 20, 2022 Accepting new patients
South Broward Hospital District CurrentSince Apr 20, 2022 Accepting new patients
Ut Physicians CurrentSince Nov 11, 2024 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Nov 11, 2024 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1150 N 35th Ave
Ste 555
Hollywood, FL 33021
Phone (954) 981-0072

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

6410 Fannin St
#135
Houston, TX 77030

6621 Fannin St
#A
Houston, TX 77030
Phone (328) 824-1000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

Interoperability endpoints

  • Direct secure messaging: sbailey322192@northwell.direct-ci.com

Organizations & group practices 6

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1770127995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 OLINVILLE AVE APT 3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST # A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHELIQUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.