Organization Active NPI

Pegasus Hospice LLC

  • Community Based Hospice Care Agency
  • Tyler, TX
National Provider Identifier
1194079814
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PEGASUS HOSPICE LLC
Practice address
1305 Doctors Dr
Tyler, TX 75701-2263
Phone
(903) 630-1001
Fax
(214) 260-0757
NPI assigned
Nov 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Authorized official

Name
Aracely Dobbins, RN
Title
Administrator
Phone
(903) 630-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1305 Doctors Dr
Tyler, TX 75701-2263

Mailing address

1616 Gateway Blvd
Richardson, TX 75080-3529
Phone (214) 267-1800

Other names 1

  • Angel Hands Hospice of East Texas Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130514000584 TX Part A Provider - Hospice 1557508371 Practice locations: Tyler, TX

Hospice certification: CCN 671799

Legal name
PEGASUS HOSPICE LLC
Doing business as
ANGEL HANDS HOSPICE OF EAST TEXAS
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 21, 2013
Last certification
Aug 30, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Oct 30, 2012 in TX
Enrollment address
1305 Doctors Dr
Ste a
Tyler, TX 75701-2263

Care Compare: Hospice

Medicare Care Compare
Listed as
Angel Hands Hospice of East TexasCCN 671799
Ownership
For-Profit
Certified
Nov 21, 2013
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2318721Pegasus Hospice Dba Angel Hands Hospice1305 Doctors Drive, Tyler, TX 75701Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory

Locations

3939 US Highway 80 E
Ste 202
Mesquite, TX 75150

1305 Doctors Dr
Ste A
Tyler, TX 75701
Phone (903) 630-1001

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Arti Patel-Cheadle Individual Corporate OfficerAdmin Mar 1, 2022 100%
W-2 Managing Employee Mar 1, 2022 100%
Bejoy Mathew Individual Corporate OfficerCfo Mar 1, 2022 100%
Corporate Director Mar 1, 2022 100%
W-2 Managing EmployeeCfo Mar 1, 2022 100%
Julio C Olivieri Individual Contracted Managing EmployeeMD; Oct 3, 2022
Johnson Johnson Chacko Individual 5% Or Greater Direct Ownership InterestOwner May 1, 2020 100%
Corporate Director May 1, 2020 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764633600000",
    "number": "1194079814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 GATEWAY BLVD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803529",
            "telephone_number": "214-267-1800",
            "fax_number": "214-260-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 DOCTORS DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012263",
            "telephone_number": "903-630-1001",
            "fax_number": "214-260-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEGASUS HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A",
        "authorized_official_last_name": "DOBBINS",
        "authorized_official_first_name": "ARACELY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-630-1001",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Hands Hospice of East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.