Active NPI 1790704963 Individual Practitioner Female Practitioner

Loretta Keese , PA

Physician Assistant • Fredericksburg, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Loretta Keese, PA is a certified Physician Assistant practicing in Fredericksburg, TX. With approximately 22 years of clinical experience since completing medical education in 2004, Loretta Keese delivers high-quality medical care to the local community at 1308 SOUTH HIGHWAY 16.

Loretta Keese is affiliated with Privia Medical Group Gulf Coast Pllc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, manual urinalysis test with examination using microscope, non-automated. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1308 South Highway 16

Fredericksburg, TX 786245058

Telephone 8309972181

Fax 8309979598

Associated Practice Facility / Clinic

🏢 Fredericksburg Clinic, Pllc Facility NPI 1033145545

Medicare Profile & Education

Medical School

Other

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Fredericksburg, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs +3.8 yrs vs City Avg

City Avg: 18.2 Yrs

State Avg: 13.9 Yrs

Regional Practice Density

7 Specialists

Practicing in Fredericksburg, TX (11140 Statewide)

Telehealth Adoption Rate

28.6% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

30.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Keese (22 Years) 22 Yrs

Fredericksburg Specialty Average (18.2 Years) 18.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	620	253	$128.43	$102.94
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	444	221	$16.19	$13.38
81000 Manual urinalysis test with examination using microscope, non-automated	190	172	$4.30	$3.88
83036 Hemoglobin A1C level	172	121	$10.68	$9.40
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	147	147	$134.39	$104.96
G0444 Annual depression screening, 5 to 15 minutes	142	142	$18.00	$15.15
93000 Routine ekg using at least 12 leads including interpretation and report	93	90	$16.75	$11.40
87804 Detection test by immunoassay with direct visual observation for influenza virus	70	32	$16.55	$16.22
82044 Urine microalbumin (protein) analysis	59	57	$7.29	$6.10
80053 Blood test, comprehensive group of blood chemicals	51	49	$43.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	50	49	$32.00	$7.61
96127 Assessment of emotional or behavioral problems	47	33	$4.93	$4.32
80061 Blood test, lipids (cholesterol and triglycerides)	43	43	$55.00	$13.12
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	41	31	$68.00	$16.20
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	37	37	$283.71	$278.04
G0009 Administration of pneumococcal vaccine	37	37	$25.00	$24.50
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	30	30	$34.71	$17.69
93922 Ultrasound study of arm and leg arteries	28	14	$82.10	$65.53
99213 Established patient office or other outpatient visit, typically 15 minutes	26	25	$96.14	$71.40
82306 Vitamin d-3 level	26	26	$111.00	$29.01
84443 Blood test, thyroid stimulating hormone (TSH)	23	23	$69.00	$16.46
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	23	20	$181.64	$146.01
99496 Transitional care management services for problem of high complexity	17	15	$238.51	$226.30
36415 Insertion of needle into vein for collection of blood sample	17	17	$11.00	$8.65
99495 Transitional care management services for problem of at least moderate complexity	15	15	$272.55	$158.15
84439 Thyroxine (thyroid chemical), free	14	14	$37.00	$8.84
G0008 Administration of influenza virus vaccine	12	12	$32.96	$28.60
90662 Influenza vaccine split virus, preservative free	11	11	$55.94	$43.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	794	277	$126.81	$103.24
81000 Manual urinalysis test with examination using microscope, non-automated	291	250	$4.45	$3.90
83036 Hemoglobin A1C level	251	155	$10.98	$9.39
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	220	220	$128.54	$105.05
G0444 Annual depression screening, 5 to 15 minutes	215	215	$18.16	$14.95
93000 Routine ekg using at least 12 leads including interpretation and report	160	153	$15.79	$11.62
99213 Established patient office or other outpatient visit, typically 15 minutes	99	80	$90.51	$73.40
G0008 Administration of influenza virus vaccine	88	86	$28.91	$28.06
90662 Influenza vaccine split virus, preservative free	86	84	$50.80	$46.93
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	75	75	$32.51	$17.69
87804 Detection test by immunoassay with direct visual observation for influenza virus	52	24	$16.55	$16.22
82044 Urine microalbumin (protein) analysis	45	45	$6.78	$5.97
96127 Assessment of emotional or behavioral problems	39	25	$4.77	$4.39
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	32	27	$68.00	$16.20
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	22	22	$283.71	$278.04
G0009 Administration of pneumococcal vaccine	22	22	$25.00	$24.50
99496 Transitional care management services for problem of high complexity	17	16	$247.51	$213.31
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$163.81	$134.37
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	12	$176.49	$146.03
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$163.81	$134.64
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	13	13	$13.89	$11.83
99495 Transitional care management services for problem of at least moderate complexity	12	11	$180.69	$166.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	652	268	$127.75	$104.08
81000 Manual urinalysis test with examination using microscope, non-automated	278	233	$4.34	$3.95
99213 Established patient office or other outpatient visit, typically 15 minutes	221	152	$89.51	$73.77
83036 Hemoglobin A1C level	218	142	$11.01	$9.49
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	217	217	$128.76	$107.38
G0444 Annual depression screening, 5 to 15 minutes	199	199	$18.34	$15.00
93000 Routine ekg using at least 12 leads including interpretation and report	157	150	$15.86	$11.54
90662 Influenza vaccine split virus, preservative free	107	104	$49.85	$47.75
G0008 Administration of influenza virus vaccine	100	97	$28.79	$28.24
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	74	74	$32.51	$17.80
96127 Assessment of emotional or behavioral problems	72	39	$4.78	$4.36
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	52	12	$40.85	$40.43
93922 Ultrasound study of arm and leg arteries	50	25	$82.10	$67.97
82044 Urine microalbumin (protein) analysis	41	41	$6.83	$6.15
87804 Detection test by immunoassay with direct visual observation for influenza virus	38	18	$18.13	$15.45
G0009 Administration of pneumococcal vaccine	28	28	$24.69	$24.30
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	27	26	$68.13	$15.71
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	22	22	$283.71	$278.55
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	16	$19.60	$11.80
90471 Administration of 1 vaccine	17	17	$21.04	$12.91
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$163.81	$137.35
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$186.37	$148.32
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$163.81	$137.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	636	265	$129.37	$107.88
81000 Manual urinalysis test with examination using microscope, non-automated	275	230	$4.87	$3.99
99213 Established patient office or other outpatient visit, typically 15 minutes	231	159	$89.54	$76.34
83036 Hemoglobin A1C level	227	132	$11.42	$9.67
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	197	197	$130.06	$110.55
G0444 Annual depression screening, 5 to 15 minutes	192	192	$18.94	$15.64
93000 Routine ekg using at least 12 leads including interpretation and report	149	148	$16.86	$12.21
90662 Influenza vaccine split virus, preservative free	119	115	$64.78	$60.68
G0008 Administration of influenza virus vaccine	119	115	$16.81	$16.10
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	87	87	$31.00	$18.05
96127 Assessment of emotional or behavioral problems	59	38	$5.02	$4.58
82044 Urine microalbumin (protein) analysis	48	48	$31.00	$6.23
93922 Ultrasound study of arm and leg arteries	46	23	$82.84	$71.34
91301 Sarscov2 vac 100mcg/0.5ml im	34	25	$0.01	$0.01
0013A Adm sarscov2 100mcg/0.5ml3rd	29	29	$16.68	$16.68
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$120.40	$119.92
G0009 Administration of pneumococcal vaccine	23	23	$16.60	$16.22
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	19	15	$39.76	$34.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$108.75	$93.43
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$168.83	$141.09
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	17	16	$16.53	$16.53
0031A Adm sarscov2 vac ad26 .5ml	16	16	$38.69	$32.21
0012A Adm sarscov2 100mcg/0.5ml2nd	14	14	$27.62	$26.81
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	13	$185.08	$151.76
94010 Test to measure expiratory airflow and volume	14	14	$30.72	$24.62
91303 Sarscov2 vac ad26 .5ml im	14	14	$0.10	$0.01
0011A Adm sarscov2 100mcg/0.5ml1st	14	14	$16.94	$16.77
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$164.09	$141.38
99496 Transitional care management services for problem of high complexity	12	12	$271.89	$233.62
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)	12	12	$58.00	$24.09
77080 Dxa bone density measurement of hip, pelvis, spine	11	11	$9.51	$8.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	509	236	$76.38	$61.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	426	237	$109.59	$90.12
81000 Manual urinalysis test with examination using microscope, non-automated	258	204	$22.00	$3.97
G0444 Annual depression screening, 5 to 15 minutes	205	205	$32.49	$15.05
83036 Hemoglobin A1C level	195	115	$45.10	$9.56
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	193	193	$115.14	$96.50
93000 Routine ekg using at least 12 leads including interpretation and report	144	138	$17.05	$14.08
G0008 Administration of influenza virus vaccine	110	105	$25.23	$16.19
90662 Influenza vaccine split virus, preservative free	107	102	$64.55	$60.29
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	106	22	$40.69	$34.85
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	82	82	$31.60	$17.72
87804 Detection test by immunoassay with direct visual observation for influenza virus	38	19	$33.92	$16.34
82044 Urine microalbumin (protein) analysis	38	38	$31.00	$6.03
93922 Ultrasound study of arm and leg arteries	37	19	$82.07	$65.38
G0009 Administration of pneumococcal vaccine	28	28	$25.00	$16.09
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	28	28	$131.00	$116.78
G0102 Prostate cancer screening; digital rectal examination	20	20	$25.39	$18.91
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	17	17	$70.26	$16.39
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$163.03	$131.60
96127 Assessment of emotional or behavioral problems	16	15	$4.90	$4.72
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	13	$142.93	$122.00
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	12	12	$16.54	$14.08
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$167.09	$143.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$105.05	$89.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	602	261	$73.49	$60.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	350	232	$107.89	$89.31
81000 Manual urinalysis test with examination using microscope, non-automated	296	225	$22.00	$3.91
83036 Hemoglobin A1C level	192	120	$45.10	$10.51
93000 Routine ekg using at least 12 leads including interpretation and report	191	171	$17.65	$13.84
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	175	175	$113.72	$95.92
G0444 Annual depression screening, 5 to 15 minutes	173	173	$17.29	$14.84
G0008 Administration of influenza virus vaccine	107	103	$25.00	$15.90
90662 Influenza vaccine split virus, preservative free	105	101	$49.18	$48.12
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	87	87	$32.55	$17.69
G0009 Administration of pneumococcal vaccine	53	53	$25.00	$15.90
82044 Urine microalbumin (protein) analysis	41	41	$31.00	$6.09
87804 Detection test by immunoassay with direct visual observation for influenza virus	36	18	$16.55	$16.22
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	27	27	$131.00	$110.52
90670 Pneumococcal vaccine for injection into muscle	26	26	$290.00	$207.17
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	25	22	$68.00	$16.20
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	23	11	$16.22	$13.74
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$168.23	$141.90
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$142.55	$120.46
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	13	13	$52.00	$14.66
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$163.21	$136.60
90471 Administration of 1 vaccine	13	13	$16.22	$13.72
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	12	12	$58.00	$32.13
99495 Transitional care management services for problem of at least moderate complexity	12	12	$160.23	$135.42
86318 Test for detection of infectious agent antibody, qualitative or semiquantitative	11	11	$55.00	$17.73
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$74.35	$62.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	549	256	$72.91	$59.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	370	232	$107.92	$88.01
81000 Manual urinalysis test with examination using microscope, non-automated	277	222	$22.00	$3.90
93000 Routine ekg using at least 12 leads including interpretation and report	184	170	$17.65	$13.77
83036 Hemoglobin A1C level	176	114	$44.80	$11.75
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	174	174	$114.36	$94.92
G0444 Annual depression screening, 5 to 15 minutes	156	156	$17.40	$14.63
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	134	24	$90.31	$75.68
G0008 Administration of influenza virus vaccine	102	97	$25.00	$19.51
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	98	98	$31.87	$19.25
90662 Influenza vaccine split virus, preservative free	97	94	$53.01	$48.14
87804 Detection test by immunoassay with direct visual observation for influenza virus	76	35	$25.97	$15.74
G0009 Administration of pneumococcal vaccine	55	55	$25.00	$19.51
82044 Urine microalbumin (protein) analysis	37	37	$31.00	$6.11
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	34	28	$68.21	$15.72
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	31	31	$129.94	$102.18
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	31	14	$21.04	$16.71
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	29	17	$68.18	$57.24
90670 Pneumococcal vaccine for injection into muscle	25	25	$290.00	$199.54
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	21	21	$168.76	$140.82
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$163.58	$135.78
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	14	14	$16.45	$13.96
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	14	11	$47.50	$19.25
96127 Assessment of emotional or behavioral problems	13	11	$6.10	$5.52
99318 Nursing facility annual assessment, typically 30 minutes	13	13	$94.63	$79.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	391	216	$71.66	$59.46
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	298	95	$90.46	$75.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	219	131	$104.89	$87.55
81000 Manual urinalysis test with examination using microscope, non-automated	181	141	$22.00	$4.24
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	132	60	$67.64	$56.61
93000 Routine ekg using at least 12 leads including interpretation and report	100	92	$17.82	$13.75
83036 Hemoglobin A1C level	94	62	$43.00	$13.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	86	86	$112.73	$93.92
G0444 Annual depression screening, 5 to 15 minutes	85	85	$34.79	$14.51
85610 Blood test, clotting time	75	11	$25.00	$5.28
87804 Detection test by immunoassay with direct visual observation for influenza virus	66	31	$46.55	$16.11
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	47	23	$25.45	$20.48
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	46	46	$31.00	$21.38
G0008 Administration of influenza virus vaccine	45	42	$25.00	$23.91
G0009 Administration of pneumococcal vaccine	41	41	$25.00	$23.91
90670 Pneumococcal vaccine for injection into muscle	41	41	$290.00	$185.47
90662 Influenza vaccine split virus, preservative free	41	41	$103.41	$47.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$104.66	$87.91
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	26	26	$166.85	$139.03
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	25	21	$133.33	$111.64
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$72.37	$60.92
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	22	20	$68.00	$16.11
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	18	18	$162.25	$132.83
82044 Urine microalbumin (protein) analysis	18	18	$31.00	$5.81
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	14	14	$16.35	$13.85

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA04251

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

210476201 (TX)

Hospital & Practice Group Affiliations

Privia Medical Group Gulf Coast Pllc

7900 Fannin St, Houston, TX 770542935

Phone: 7135127500

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners

Emily Evans , MS, RN, FNP-BC

Nurse Practitioner - Family

NPI 1033366109

Master of Science, Registered Nurse, Family Nurse Practitioner (Board Certified)

Kathleen Fryburger , PA

Physician Assistant

NPI 1053396077

Physician Assistant

Dr. Jennifer Mayben , MD

Internal Medicine

NPI 1194746685

Doctor of Medicine (M.D.)

Dr. Charles Burg , MD

Family Medicine

NPI 1306880794

Doctor of Medicine (M.D.)

Dr. Rebecca Daley , DO

Family Medicine

NPI 1356348288

Doctor of Osteopathic Medicine (D.O.)

Dr. Michael Johnson , MD

Internal Medicine

NPI 1386653236

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active April 04, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location April 04, 2011

Registered at 1308 SOUTH HIGHWAY 16, FREDERICKSBURG, TX 786245058 (Tel: 8309972181)

📍

Updated Business Mailing Address April 04, 2011

Registered at 1308 SOUTH HIGHWAY 16, FREDERICKSBURG, TX 786245058 (Tel: 8309972181)

👤

Provider Name / Credentials Updated April 04, 2011

Recorded as LORETTA KEESE, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 04, 2011

Physician Assistant (License #PA04251 in TX)

🟢

Initial NPI Registration & Enumeration July 19, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1790704963

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 19, 2006

Last Update: April 04, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1308 South Highway 16

Fredericksburg, TX 786245058

Phone: 8309972181

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.