Jackeline Bobadilla, MSPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18520 Issued in TX

Practice address

5750 Pineland Dr
Dallas, TX 75231-5300

Phone

(214) 221-0855

NPI assigned

May 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (2 of 5)

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• Healing Hands Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
  • NPI 1306287529
  NPD (past)

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1306373642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 PINELAND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315300",
            "telephone_number": "214-221-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 PINELAND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315300",
            "telephone_number": "214-221-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBADILLA",
        "first_name": "JACKELINE",
        "name_prefix": "Mrs.",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "PA18520",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Knox Boatner IV
• Jason M Boatright, CRNA
• Steve Micheal Boatright, PHARM.D.
• Bob L. Pansick, MD, Faao, PA
• Phyllis Bob-Harris
• Bobbi Garmany, Ms, LPC Counseling, PC
• Aminat Bobcombe, D.O
• Gabriela T Bober, M.D.
• Jordan Boboltz, OTR, ATP
• Ashley Denise Bocanegra, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.