Individual provider Active NPI

Alessandra Andren, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1922732643
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15872 Issued in TX
Practice address
4411 Medical Dr Ste 300
San Antonio, TX 78229-3824
Phone
(210) 614-5400
NPI assigned
Jul 11, 2022
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 PA15872 TX Primary

Addresses

Primary practice location

4411 Medical Dr Ste 300
San Antonio, TX 78229-3824

Mailing address

4411 Medical Dr Ste 300
San Antonio, TX 78229-3824

Other names 1

  • Ally Russo Former name

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
I20220818003661 TX Practitioner - Physician Assistant 5698158970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9635 Huebner Rd
San Antonio, TX 78240-1512
Phone (210) 692-1181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as group
Quality
75.23
Promoting interoperability
99
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15872TXMDPhysician Assistant

Organizations & group practices 1

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 4

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1922732643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293824",
            "telephone_number": "210-614-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREN",
        "first_name": "ALESSANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLY",
            "last_name": "RUSSO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.