Individual provider Active NPI

Pamela Proctor Criscitiello, AGPCNP, MSN, RN, OCN

  • Adult Health Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1790479152
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG05230129 Issued in TX
Practice address
2215 E Villa Maria Rd Ste 110
Bryan, TX 77802-2585
Phone
(979) 776-2000
Fax
(866) 733-2572
NPI assigned
Jun 7, 2023
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG05230129 TX Primary

Addresses

Primary practice location

2215 E Villa Maria Rd Ste 110
Bryan, TX 77802-2585

Mailing address

812 Pine Valley Dr
College Station, TX 77845-4460
Phone (305) 298-8973

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
I20231103002635 TX Practitioner - Nurse Practitioner 6901253566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2435 Harvey Mitchell Pkwy S
College Station, TX 77845-5000
Phone (979) 776-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AG05230129TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Hematology Oncology Associates, PA CurrentSince Sep 2, 2023 Accepting new patients
Brazos Valley Hematology Oncology Associates, PA CurrentSince Sep 2, 2023 Accepting new patients

Locations

2215 E Villa Maria Rd
Ste 110
Bryan, TX 77802
Phone (979) 776-2000

2435 Harvey Mitchell Pkwy S
College Station, TX 77845
Phone (979) 776-2000

2435 Harvey Mitchell Pkwy S
Ste 110
College Station, TX 77845

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

Hospital & facility affiliations 2

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1790479152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 PINE VALLEY DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454460",
            "telephone_number": "305-298-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E VILLA MARIA RD STE 110",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022585",
            "telephone_number": "979-776-2000",
            "fax_number": "866-733-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISCITIELLO",
        "first_name": "PAMELA",
        "middle_name": "PROCTOR",
        "credential": "AGPCNP, MSN, RN, OCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AG05230129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.