Individual provider Active NPI

Bobby I Pierson, PA

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1295775229
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04240 Issued in TX
Practice address
3601 4TH St
Suite 3A105
Lubbock, TX 79430-8103
Phone
(806) 743-2391
Fax
(806) 743-5687
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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 PA04240 TX Primary

Addresses

Primary practice location

3601 4TH St
Suite 3A105
Lubbock, TX 79430-8103

Mailing address

3601 4TH St # Ms 8321
Lubbock, TX 79430-8321
Phone (806) 743-3849

Other identifiers 5

IdentifierTypeStateIssuer
202006417MedicaidNM
183145501MedicaidTX
200081390AMedicaidOK
202006417OtherNMPRESBYTERIAN COMMERCIAL
135127100OtherTXFIRSTCARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TTUneuro@direct.myteamcare.com Direct

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
I20060814000216 TX Practitioner - Physician Assistant 1153324108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-0002

3601 4TH St
Lubbock, TX 79430-8321
Phone (806) 743-2391

4000 24TH St
Lubbock, TX 79410-1894
Phone (806) 743-2373

4002 24TH St
Lubbock, TX 79410-1894
Phone (806) 743-1501

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Apr 11, 2006 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Apr 11, 2006 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients

Locations

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
Ste 3A105
Lubbock, TX 79430
Phone (806) 743-2391

3601 4th St
Fl 3
Lubbock, TX 79430
Phone (806) 743-2340

3601 4th St
Stop 8321
Lubbock, TX 79430
Phone (806) 743-2391

Interoperability endpoints

  • Direct secure messaging: bob.pierson@direct.myteamcare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1295775229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 8321",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794308321",
            "telephone_number": "806-743-3849",
            "fax_number": "806-743-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "SUITE 3A105",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794308103",
            "telephone_number": "806-743-2391",
            "fax_number": "806-743-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "BOBBY",
        "middle_name": "I",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202006417",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183145501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200081390A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "202006417",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "135127100",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TTUneuro@direct.myteamcare.com",
            "affiliation": "N",
            "endpointDescription": "Neurology",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3601 4th St",
            "address_2": "Suite 3A105",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794308103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.