Individual provider Active NPI

Jason McKnight, M.D.

  • Family Medicine Physician
  • Bryan, TX
National Provider Identifier
1023429321
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q5867 Issued in TX
Practice address
2900 E 29TH St
Ste. 100
Bryan, TX 77802-2622
Phone
(979) 436-0485
Fax
(979) 436-0063
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X Q5867 TX Primary

Addresses

Primary practice location

2900 E 29TH St
Ste. 100
Bryan, TX 77802-2622

Mailing address

2900 E 29TH St Ste 100
Bryan, TX 77802-2623
Phone (979) 436-0485

Other identifiers 1

IdentifierTypeStateIssuer
353580901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151124000191 TX Practitioner - Family Practice 4082914080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Aandm University System Health Science CenterGroup PAC ID 8224008644, 40 clinicians

Practice addresses (Care Compare)

2900 E 29TH St
Suite 200
Bryan, TX 77802-2623
Phone (979) 776-8440

Hospital & facility affiliations

  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5867TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center CurrentSince Oct 6, 2015 Accepting new patients
Texas a&M University System Health Science Center Family Medicine CurrentSince Oct 6, 2015 Accepting new patients

Locations

2900 E 29th St
Ste 100
Bryan, TX 77802
Phone (979) 436-0485

1301 Memorial Dr
Ste 100
Bryan, TX 77802
Phone (979) 862-4465

2900 E 29th St
Ste 200
Bryan, TX 77802
Phone (979) 436-0483

2900 E 29th St
Bryan, TX 77802
Phone (979) 436-0700

1905 Dove Crossing Ln
Ste A
Navasota, TX 77868
Phone (936) 825-0755

210 S Judson St
Navasota, TX 77868
Phone (936) 825-6585

Interoperability endpoints

  • Direct secure messaging: jmcknight32309@texasamuniversity.gardenplot.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1023429321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022623",
            "telephone_number": "979-436-0485",
            "fax_number": "877-601-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST",
            "address_2": "STE. 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022622",
            "telephone_number": "979-436-0485",
            "fax_number": "979-436-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "353580901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.