Jay Takata

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

K7400 Issued in TX

Practice address

115 S Murchison St
Athens, TX 75751-2662

Phone

(903) 677-3737

Fax

(903) 677-6014

NPI assigned

Sep 28, 2007

Last updated

Jul 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, NV2 enrollments

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 2

Specialty

Gastroenterology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Carson Tahoe Physician ClinicsGroup PAC ID 1153479027, 104 clinicians

CTH Physicians ClinicGroup PAC ID 1254787203, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtakata355924@ahs.direct-ci.com
• Direct secure messaging: jtakata803120@direct.med.utah.edu

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

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Carson Tahoe Physician Clinics

  • Internal Medicine Physician
  • Carson City, NV
  • NPI 1023265717
  Medicare reassignment Care Compare group NPD
• CTH Physicians Clinic

  • Internal Medicine Physician
  • Carson City, NV
  • NPI 1306533732
  Medicare reassignment Care Compare group NPD
• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Medicare reassignment NPD
• Athens Gastroenterology PA

  • Gastroenterology Physician
  • Athens, TX
  • NPI 1568473916
  Authorized official Same address or phone
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988
  NPD

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751760000000",
    "number": "1083801518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S MURCHISON ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757512662",
            "telephone_number": "903-677-3737",
            "fax_number": "903-677-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S MURCHISON ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757512662",
            "telephone_number": "903-677-3737",
            "fax_number": "903-677-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKATA",
        "first_name": "JAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "K7400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031287801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Sullivan
• Pamela Evette Summers, APRN
• Michael Swartwood, D.O.
• Jessica Leigh Swinnea, LMSW
• Shawn Tai, M.D.
• Melissa Tatum, LPC
• Ralph Wayne Templin, D.O.
• Kaylie Alexandra Temporal, PA
• Teri Lynne Baumgartner M.D. PLLC (Athen's Women's Health Center)
• Teri Lynne Baumgartner PLLC (Athens Women's Health Center)

• Gastroenterology Physician in Athens, TX
• Providers in Athens, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.