Individual provider Active NPI

Jennifer D Decker, PA-C

  • Physician Assistant
  • Round Rock, TX
National Provider Identifier
1518201284
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52054 Issued in MT
Practice address
300 University Blvd
Round Rock, TX 78665-1032
Phone
(254) 724-1111
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14935 TX
Physician Assistant 363A00000X 52054 MT Primary

Addresses

Primary practice location

300 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

1101 26th St S Fl 5
Great Falls, MT 59405-5161
Phone (406) 731-8888

Other practice location 2

703 S Fleishel Ave Ste 5000
Tyler, TX 75701-2015
Phone (903) 525-2992

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.decker.p1@direct.benefisbmg.nextgenshare.com Benefis Hospitals, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161215001765 MT Practitioner - Physician Assistant 6901058221 Reassigns benefits to 1 organization
I20220214001951 TX Practitioner - Physician Assistant 6901058221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1086NHMDPhysical Therapist
2233AKMDPhysical Therapy Assistant
52054MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc CurrentSince Feb 1, 2017 Accepting new patients
Scott and White Clinic CurrentSince Feb 4, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 18, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 18, 2023 Accepting new patients
Frontier Cardiovascular Corporation Past Accepting new patients

Locations

1300 28th St S
Fl 2
Great Falls, MT 59405
Phone (406) 455-4320

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

703 S Fleishel Ave
Ste 5000
Tyler, TX 75701
Phone (903) 525-2992

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1518201284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "254-724-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 26th St S Fl 5",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-525-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECKER",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14935",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "52054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.decker.p1@direct.benefisbmg.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals, Inc",
            "address_1": "1101 26th St S Fl 5",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.