Samuel L Jurado Jr., P.A.
Individual provider Active NPI Physician Assistant · Plainview, TX
NPI 1275764862 · NPPES record last updated Apr 1, 2020
Key facts
- NPI
- 1275764862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 2601 Dimmitt Rd
102
Plainview, TX 79072-1833 - Phone
- (806) 293-8561
- Fax
- (806) 293-7354
- NPI assigned
- Jul 31, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Regence Health Network Inc
Practice addresses (Care Compare)
125 W Park Ave
Hereford, TX 79045-4201
Phone (806) 364-7688
3113 Ross St
Amarillo, TX 79103-2700
Phone (806) 374-7341
Hospital & facility affiliations
- Hereford Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090825000327 | TX | Practitioner - Physician Assistant | 7517011604 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regence Health Network Inc | Current |
Accepting new patients | |
| Regence Health Network Inc | Current |
Accepting new patients |
Locations
3113 Ross St
Amarillo, TX 79103
Phone (806) 374-7341
125 W Park Ave
Hereford, TX 79045
Phone (806) 364-4377
2601 Dimmitt Rd
#102
Plainview, TX 79072
Phone (806) 293-2270
2801 W 8th St
Plainview, TX 79072
Phone (806) 293-0921
Interoperability endpoints
- sam.jurado.1@12120.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TX | Yes |
Addresses
Primary practice location
2601 Dimmitt Rd
102
Plainview, TX 79072-1833
Mailing address
2801 W 8TH St
Plainview, TX 79072-6737
Phone (806) 293-8561
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209443501 | Medicaid | TX | |
| 135077903 | Medicaid | TX | |
| 805N46 | Other | BCBS TEXAS |
Other providers in Plainview, TX
- Joe D Bradshaw
- Joe Dale Bradshaw
- Stacy Johnson
- Jon Watkins M.D. P.a.
- Kevin C Jones
- Bhupala Raju Kallepalli
- Jiwon Kang
- Amy Lynn Kellison
- Larry Melvin Keltz
- Kevin L Stewart, MD, PA
All providers in Plainview, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.