Kelly Ann Gully, PA-C
NPI 1063659878ActiveIndividual· Physician Assistant· College Station, TX
Physician Assistant (PA-C) with Brazos Valley Physicians Alliance, practicing in College Station, Texas. 119 Medicare patients in 2024, $15,623 paid; all of their 104 Part D prescriptions were generic. Lists Chi St Joseph Health Regional Hospital and 1 other hospital as hospital affiliations.
Overview
| NPI | 1063659878 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jan 15, 2009 |
| Last updated in NPPES | Dec 9, 2021 |
| Certified by provider | Dec 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA06059 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 119 |
|---|---|
| Services billed | 1,301 across 54 procedure codes |
| Paid by Medicare | $15,623 |
Part D prescriptions in 2024
| Prescriptions (claims) | 104 · 118 30-day fills |
|---|---|
| Patients | 55 |
| Total drug cost | $834.48 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2008 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Brazos Valley Physicians AllianceBryan, TX · 22 clinicians
Hospital affiliations
- Chi St Joseph Health Regional HospitalBryan, TX
- Physicians Centre,theBryan, TX
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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