Organization Active NPI

Alexandra Pellicena MD PA

  • Obstetrics & Gynecology Physician
  • Houston, TX
National Provider Identifier
1790016376
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ALEXANDRA PELLICENA MD PA
Practice address
1919 North Loop W
Suite 215
Houston, TX 77008-1374
Phone
(713) 370-7325
Fax
(713) 574-4683
NPI assigned
Jan 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Dr. Alexandra Pellicena, MDNPI 1578564886
Title
President
Phone
(713) 370-7325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1919 North Loop W
Suite 215
Houston, TX 77008-1374

Mailing address

1919 North Loop W
Suite 215
Houston, TX 77008-1374
Phone (713) 370-7325

Other identifiers 1

IdentifierTypeStateIssuer
210320201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100225000894 TX Part B Supplier - Clinic/Group Practice 7012051295 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2004262Alexandra Pellicena MD PA1919 North Loop West # 215, Houston, TX 77008Certificate of waiverMar 1, 2028

National Provider Directory

National Provider Directory

Locations

1919 North Loop W
Ste 215
Houston, TX 77008
Phone (713) 370-7325

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1790016376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NORTH LOOP W",
            "address_2": "SUITE 215",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081374",
            "telephone_number": "713-370-7325",
            "fax_number": "713-574-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NORTH LOOP W",
            "address_2": "SUITE 215",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081374",
            "telephone_number": "713-370-7325",
            "fax_number": "713-574-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRA PELLICENA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "PELLICENA",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-370-7325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210320201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.