Active NPI
Pegasus Hospice LLC
- Community Based Hospice Care Agency
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Texas
- Ownership
- For-Profit
- Certified
- Nov 21, 2013
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2318721 | Pegasus Hospice Dba Angel Hands Hospice | Certificate of waiver | Feb 17, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Arti Patel-Cheadle | Corporate Officer | Mar 1, 2022 | 100% |
| W-2 Managing Employee | Mar 1, 2022 | 100% | |
| Bejoy Mathew | Corporate Officer | Mar 1, 2022 | 100% |
| Corporate Director | Mar 1, 2022 | 100% | |
| W-2 Managing Employee | Mar 1, 2022 | 100% | |
| Julio C Olivieri | Contracted Managing Employee | Oct 3, 2022 | |
| Johnson Johnson Chacko | 5% Or Greater Direct Ownership Interest | 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.
-
- Internal Medicine Physician
- Mesquite, TX
- NPI 1881605780
Contracted Managing Employee
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.