Becky Lynn Gorham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001731 Issued in IL

Practice address

19026 Ridgewood Pkwy Ste 311
San Antonio, TX 78259-5502

Phone

(833) 210-4673

NPI assigned

Mar 6, 2007

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

Other identifiers 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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smithson Valley Family Medicine, LLPGroup PAC ID 3779597927, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Smithson Valley Family Medicine, LLP

  • Family Medicine Physician
  • Spring Branch, TX
  • NPI 1841322013
  Medicare reassignment Care Compare group
• Community Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329
  Medicare reassignment
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134

  Physician Assistant

  NPD (past)

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

• Christus Santa Rosa Health Care Corporation

  • General Acute Care Hospital
  • New Braunfels, TX
  • NPI 1114725033
  Care Compare affiliation
• Christus Santa Rosa Health Care Corporation

  • General Acute Care Hospital
  • San Marcos, TX
  • NPI 1447883301
  Care Compare affiliation

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1912037201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95590",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950590",
            "telephone_number": "801-352-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19026 RIDGEWOOD PKWY STE 311",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782595502",
            "telephone_number": "833-210-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3619 Paesanos Pkwy Ste 302",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782311259",
            "country_code": "US",
            "telephone_number": "210-802-4662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20770 US Highway 281 N # 108-439",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782587655",
            "country_code": "US",
            "telephone_number": "210-802-4662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "BECKY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA10525",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mac Kenzie Gorecki, CNIM
• Wendy Rose Gorecki, PTA
• Mark Gorelik, MD
• Joseph Gorena
• Kassandra Gorena, DDS
• Sudheer Reddy Gorla, M.D
• Amber Gorman, OTR
• Lisa Gorn, D.O.
• Amy Nicole Gorniak, MA
• Edralin Emily Gorospe-Yadao

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.
• 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.