MR. GARY S COOK (P.A.) – Medical Physician Assistant, NPI 1154325611

MR. GARY S COOK (P.A.) is a healthcare provider. based in Port lavaca, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. PA0086 (TX). The NPI Number for MR. GARY S COOK (P.A.) is 1154325611

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
MR. GARY S COOK (P.A.)
NPI
1154325611
Phone
(361) 746-1588
Address
1207 N VIRGINIA ST
Enumeration Date
11 June 2005
Last Update Date
1 May 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4092673143
Graduation Year
1989 (37 years ago)
PAC ID
5799717864
Group Practice PAC ID
0244225670
Professional Enrollment ID
I20110315001063
Address ID
TX775141638AN200XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

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Provider Addresses for MR. GARY S COOK (P.A.)

  • 1207, North Virginia Street, Port Lavaca, Calhoun County, Texas, 77979, United States

    PORT LAVACA, TX 779792506

    Phone: (361) 746-1588

    Fax: (361) 400-1588

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110315001063IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77979)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244225670View full group profile
NameSpecialtyState
Family PracticeTX
Nurse PractitionerTX
Family PracticeTX
Family PracticeTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What NPI should I save for MR. GARY S COOK (P.A.)?
Save NPI 1154325611 if you need a stable reference for MR. GARY S COOK (P.A.).
Does this profile mean MR. GARY S COOK (P.A.) is currently active?
Yes — MR. GARY S COOK (P.A.) appears active in the national provider directory.
Can you summarize MR. GARY S COOK (P.A.)'s specialty in plain language?
Clinically, the directory lists MR. GARY S COOK (P.A.) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. GARY S COOK (P.A.)?
The page summarizes Port Lavaca, Texas for MR. GARY S COOK (P.A.); expand the address list for detail.
How can I contact MR. GARY S COOK (P.A.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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