VANESSA LYNN ELLEDGE (P.A.-C) – Physician Assistant, NPI 1467675454

VANESSA LYNN ELLEDGE (P.A.-C) is a healthcare provider. based in Kingwood, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.-C. They hold a License No. PA04602 (TX). The NPI Number for VANESSA LYNN ELLEDGE (P.A.-C) is 1467675454

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
VANESSA LYNN ELLEDGE (P.A.-C)
NPI
1467675454
Phone
(281) 312-8521
Address
22710 PROFESSIONAL DR
Enumeration Date
10 April 2007
Last Update Date
25 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2813575515
Graduation Year
2005 (21 years ago)
PAC ID
6103049127
Group Practice PAC ID
9133213192
Professional Enrollment ID
I20140520002385
Address ID
TX773395705KI22698DRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for VANESSA LYNN ELLEDGE (P.A.-C)

  • 22710 PROFESSIONAL DR

    SUITE 202

    KINGWOOD, TX 773396008

    Phone: (281) 312-8521

    Fax: (281) 359-7971

    Type: Mailing

  • 22698 PROFESSIONAL DR STE 110

    KINGWOOD, TX 773395705

    Phone: (281) 312-8521

    Type: Mailing

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: 2014-05-20

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
I20140520002385IPhysician 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes10476$0
99213Established patient office or other outpatient visit, 20-29 minutes6752$0
View full utilization report →

Insurance plans in this area (ZIP 77339)

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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: 9133213192View full group profile
NameSpecialtyState
-TX
Interventional Cardiology, Cardiovascular Disease (Cardiology)TX
-TX
Cardiovascular Disease (Cardiology)TX
Internal Medicine, Infectious DiseaseTX
Family PracticeTX
-TX
Pulmonary DiseaseMO
-TX
-TX

Reviews

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Frequently asked questions

Can I verify VANESSA LYNN ELLEDGE (P.A.-C) with an NPI only?
You can start verification with NPI 1467675454 for VANESSA LYNN ELLEDGE (P.A.-C), then check state licensing separately.
Can I rely on VANESSA LYNN ELLEDGE (P.A.-C) being an active provider?
As of the registry snapshot, VANESSA LYNN ELLEDGE (P.A.-C) is marked active.
What is VANESSA LYNN ELLEDGE (P.A.-C)'s primary classification?
Physician Assistant is the headline specialty for VANESSA LYNN ELLEDGE (P.A.-C) here. Clinical services aligned with this taxonomy classification.
What address line appears for VANESSA LYNN ELLEDGE (P.A.-C)?
VANESSA LYNN ELLEDGE (P.A.-C)'s geographic hint is Kingwood, Texas in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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