Individual provider Active NPI

Richard A Jameson, PA

  • Physician Assistant
  • Mineola, TX
National Provider Identifier
1124059589
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00460 Issued in TX
Practice address
1302 N Pacific St
Mineola, TX 75773-1022
Phone
(903) 569-5383
NPI assigned
Jul 5, 2006
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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 PA00460 TX Primary

Addresses

Primary practice location

1302 N Pacific St
Mineola, TX 75773-1022

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other identifiers 3

IdentifierTypeStateIssuer
181502903MedicaidTX
858N25OtherTXBCBS
75-2616977-021OtherTXTRICARE

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
I20070220000579 TX Practitioner - Physician Assistant 4587766688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Nov 7, 2011 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 7, 2011 Accepting new patients
Athens Emergency Medicine Associates PA Past Accepting new patients
Starks Medical Past Accepting new patients
East Texas Medical Center Healthcare Associates Past Accepting new patients

Locations

764 W Commerce St
Fairfield, TX 75840
Phone (903) 389-2181

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

1302 N Pacific St
Mineola, TX 75773
Phone (903) 525-7830

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

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

Interoperability endpoints

  • Direct secure messaging: rjameson355109@ahs.direct-ci.com

Organizations & group practices 6

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.

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1124059589",
    "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": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 N PACIFIC ST",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757731022",
            "telephone_number": "903-569-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMESON",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181502903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "858N25",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-021",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, TX

Sources for this page

Verify at the official NPI Registry.