Jason Buckaloo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19895 Issued in TX

Practice address

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954

Phone

(903) 596-3844

NPI assigned

Feb 24, 2021

Last updated

Jun 16, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

  Single Specialty

  Medicare reassignment Care Compare group NPD
• ER Care of CFL LLC

  dba ER Care

  • Urgent Care Clinic/Center
  • Orlando, FL
  • NPI 1295470060
  Medicare reassignment
• Orlando Physicians Network Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1568693554
  Medicare reassignment
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Heathrow Internal Medicine LLC

  • Family Medicine Physician
  • Lake Mary, FL
  • NPI 1033387865

  Single Specialty

  NPD (past)
• Paramount Urgent Care Inc

  dba Paramount Urgent Care Clermont

  • Clinic/Center
  • Clermont, FL
  • NPI 1629440078
  NPD (past)

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

• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1164016663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKALOO",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19895",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA19895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA19895",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124305100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "PAT9117647",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Hayes (BH Contractor)
• Bryana Shea Bryce, CST/ CSFA
• Btdi JV, LLP (Touchstone Imaging Tyler)
• Eric Buchanan, LVN
• James Brant Buchinger, MD
• Stephanie Buckmaster
• Lynn Bucko
• Buckskin 903 Ventures, LLC (Home Instead)
• Paul Budd
• Monica Buelman

• Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.