MS. CANDICE ROSEANNE PELLEGRINO M.P.A.C., P.A.-C
NPI 1922022938
Physician Assistant - Medical in Round Rock, TX

Q: What is Candice Pellegrino's NPI number?

The NPI number for Candice Pellegrino is 1922022938. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Q: What is Candice Pellegrino's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since July 26, 2006PECOS Enrolled

302 UNIVERSITY BLVD, ROUND ROCK, TX 78665(512) 509-0200 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 17, 2024, Oct 24, 2019 (2 updates tracked since 2019).

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About Ms. Candice Roseanne Pellegrino M.p.a.c., P.a.-c NPPES

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

MS. CANDICE ROSEANNE PELLEGRINO M.P.A.C., P.A.-C (NPI 1922022938) is an individual medical provider in Round Rock, Texas, licensed in Texas (PA01105) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Sulphur Springs.

NPPES Registry Identity

NPI1922022938

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. CANDICE ROSEANNE PELLEGRINOCredential: M.P.A.C., P.A.-C

Location Address302 UNIVERSITY BLVDRound Rock, TX 78665-1032

Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (254) 724-8800

Phone(512) 509-0200

Sole ProprietorYes

Enumeration DateJuly 26, 2006

Last NPPES UpdateMay 22, 20242 updates tracked since enumeration

NPPES CertifiedMay 22, 2024

✔ NPI 1922022938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363AM0700X

License✔ Licensed in TX · PA01105

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA01105 (TX)

302 UNIVERSITY BLVD, Round Rock, TX 78665

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Secondary Practice Location 1

Location 1100 Medical CirSulphur Springs, TX 75482-2138 · Phone (903) 438-8330

Other Identifiers 1

Other1821185299TX · Agency (bvcaa, Inc.) Npi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Candice Roseanne Pellegrino M.p.a.c., P.a.-c 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.

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.

HIRUT NICODIMOS

Physician Assistant (Medical)