MARY WALSH
NPI 1700619319
Physician Assistant - Surgical in Houston, TX

Q: What is Mary Walsh's NPI number?

The NPI number for Mary Walsh is 1700619319. It was assigned to this individual provider in the NPPES registry on August 21, 2024.

Q: What is Mary Walsh's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Mary Walsh was last updated on May 27, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 21, 2024PECOS Enrolled

6720 BERTNER AVE, HOUSTON, TX 77030(713) 798-1000 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 27, 2026, Mar 12, 2026, Aug 21, 2024 (3 updates tracked since 2024).

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About Mary Walsh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY WALSH (NPI 1700619319) is an individual surgical provider in Houston, Texas, licensed in Texas (PA20085) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Emory University School Of Medicine (2025).

NPPES Registry Identity

NPI1700619319

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameMARY WALSH

Location Address6720 BERTNER AVEHouston, TX 77030-2604

Mailing Address1518 Columbia StHouston, TX 77008-4535 · (703) 789-5600

Phone(713) 798-1000

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2025

Enumeration DateAugust 21, 2024

Last NPPES UpdateMay 27, 20263 updates tracked since enumeration

NPPES CertifiedMay 27, 2026

✔ NPI 1700619319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in TX · PA20085

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA20085 (TX)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

6720 BERTNER AVE, Houston, TX 77030

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Secondary Practice Locations 2

Location 11462 Clifton Rd NE Ste 280Atlanta, GA 30322-1063 · Phone (404) 727-7825

Location 21977 Butler BlvdHouston, TX 77030-4101 · Phone (713) 798-5841

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Walsh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698245124

PECOS Enrollment IDI20260526003837

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.