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ALYSSA GRACE RUNCO
NPI 1760941850
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Houston, TX

Active since March 18, 2019PECOS Enrolled
1 BAYLOR PLZ # BCM320, HOUSTON, TX 77030(832) 824-1170(832) 825-9302 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Alyssa Grace Runco NPPES

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

ALYSSA GRACE RUNCO (NPI 1760941850) is an individual neurology with special qualifications in child neurology provider in Houston, Texas, licensed in Arizona (73487) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1760941850
Entity TypeIndividualFemale
Primary Taxonomy2084N0402X
Provider Legal NameALYSSA GRACE RUNCO
Location Address1 BAYLOR PLZ # BCM320Houston, TX 77030-3411
Mailing Address1 Baylor Plz # Bcm320Houston, TX 77030-3411 · (832) 824-1170 · Fax (832) 825-9302
Phone(832) 824-1170
Fax(832) 825-9302
Sole ProprietorNo
Enumeration DateMarch 18, 2019
Last NPPES UpdateJuly 15, 2025
NPPES CertifiedJuly 15, 2025
✔ NPI 1760941850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in AZ · 73487
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
1 BAYLOR PLZ # BCM320, Houston, TX 77030
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Other Names 1

Former Name (1)Alyssa Grace Domingue Md

Secondary Practice Location 1

Location 11919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-1000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alyssa Grace Runco is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Alyssa Runco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Phoenix Children's Medical Group
995 mi
Multi-Specialty
5131 E SOUTHERN AVE
Mesa, AZ 85206
  • Reassigned Medicare billing, Arizona enrollment
  • Medicare enrollment name: Phoenix Children's Hospital
  • 1,416 clinicians in this Medicare group
NPI 1487814240 (602) 933-0002

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHANH LINH NGUYEN MD
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
SRAVYA REDDY GURIVIREDDYGARI MD, MPH
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
COURTNEY THUY HANG HUYNH
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
ASHWIN SRIVATSAV
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
CHARLES BURKE
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
LAWRENCE WILLIAM MORRIS HAMILTON
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
DR. ALISHA SADHWANI MBBS, BSC
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170
ELLEN WITTE MUELLER MD
Pediatrics
1 BAYLOR PLZ # BCM320
HOUSTON, TX 77030
Harris County (832) 824-1170

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alyssa Runco's NPI number?

The NPI number for Alyssa Runco is 1760941850. It was assigned to this individual provider in the NPPES registry on March 18, 2019. The provider is also known as Alyssa Grace Domingue MD.

Where is Alyssa Runco located?

Alyssa Runco practices at 1 Baylor Plz # Bcm320, Houston, TX 77030. The listed phone number is (832) 824-1170.

What is Alyssa Runco's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Alyssa Runco enrolled in Medicare?

Yes. Alyssa Runco is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alyssa Runco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alyssa Runco reassigns Medicare benefits to Phoenix Children's Medical Group (Mesa, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alyssa Runco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alyssa Runco was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.