Individual provider Active NPI

Jacob Daniel Chaney, PA

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1114969060
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02875 Issued in TX
Practice address
1327 Troup Hwy
Tyler, TX 75701-4443
Phone
(903) 510-8840
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02875 TX Primary

Addresses

Primary practice location

1327 Troup Hwy
Tyler, TX 75701-4443

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other practice location 1

910 E Houston St Ste 330
Tyler, TX 75702-8368
Phone (903) 606-7995

Other practice location 2

8591 S Broadway Ave
Tyler, TX 75703-5470
Phone (903) 596-9173

Other identifiers 5

IdentifierTypeStateIssuer
776514OtherTXMEDICARE
75-2616977-042OtherTXTRICARE
183908601MedicaidTX
183908603MedicaidTX
8Y9987OtherTXBCBS OF TEXAS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000861 TX Practitioner - Physician Assistant 4981653607 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

3203 S Main St
Christus Trinity Clinic
Lindale, TX 75771-7727
Phone (903) 266-4000

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

8389 S Broadway Ave
Tyler, TX 75703-5408
Phone (903) 606-6500

8591 S Broadway Ave
Tyler, TX 75703-5470
Phone (903) 606-8840

910 E Houston St
Tyler, TX 75702-8364

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jun 22, 2009 Accepting new patients
Mother Frances Hospital Jacksonville Current Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jan 19, 2019 Accepting new patients
Trincare Inc Current Accepting new patients
Sound Inpatient Physicians of Texas I, Inc CurrentSince Aug 10, 2014 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 22, 2009 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc CurrentSince Aug 10, 2014 Accepting new patients
Southeast Emergency Physician Associates, P.a. Past Accepting new patients
Beaumont Bone & Joint Institute, PA PastSince Aug 10, 2025 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

323 E Hawkins Pkwy
Ste A
Longview, TX 75605
Phone (903) 758-2746

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

8591 S Broadway Ave
Tyler, TX 75703
Phone (903) 596-9173

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: jchaney5603@christushealth.direct-ci.net

Organizations & group practices 12

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1114969060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014443",
            "telephone_number": "903-510-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-606-7995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8591 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757035470",
            "country_code": "US",
            "telephone_number": "903-596-9173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "776514",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-042",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183908601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183908603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8Y9987",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.