NPIMap

Individual provider Active NPI

Laura Hollis Peterkin, PA

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1972661429
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA03086 Issued in TX
Practice address
275 Lantern Bend Dr Ste 200
Houston, TX 77090-2831
Phone
(281) 440-0101
Fax
(281) 440-1153
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA03086 TX Primary

Addresses

Primary practice location

275 Lantern Bend Dr Ste 200
Houston, TX 77090-2831

Mailing address

275 Lantern Bend Dr Ste 200
Houston, TX 77090-2831
Phone (281) 440-0101

Other names 1

  • Mrs. Laura Hollis Peterkin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100419000518 TX Practitioner - Physician Assistant 2961539283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Vision Park Blvd
Shenandoah, TX 77384-3005
Phone (936) 321-0033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.44 of 100Reported as group
Quality
77.71
Promoting interoperability
95
Improvement activities
40
Cost
67.93

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: lpeterkin53389@memorialhermann.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1972661429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 LANTERN BEND DR STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902831",
            "telephone_number": "281-440-0101",
            "fax_number": "281-440-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 LANTERN BEND DR STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902831",
            "telephone_number": "281-440-0101",
            "fax_number": "281-440-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "LAURA",
        "middle_name": "HOLLIS",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "PETERKIN",
            "middle_name": "HOLLIS",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.