Individual provider Active NPI

Joseph Whittaker, MPAS, PA-C

  • Physician Assistant
  • Paris, TX
National Provider Identifier
1639830391
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15211 Issued in TX
Practice address
865 Deshong Dr
Paris, TX 75460-9313
Phone
(903) 767-1111
NPI assigned
Jan 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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 PA15211 TX Primary

Addresses

Primary practice location

865 Deshong Dr
Paris, TX 75460-9313

Mailing address

10108 Candlebrook Dr
Dallas, TX 75243-5059
Phone (214) 808-6494

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
I20230801002197 TX Practitioner - Physician Assistant 4880055227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.43 of 100Reported as group
Quality
93.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1639830391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10108 CANDLEBROOK DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435059",
            "telephone_number": "214-808-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 DESHONG DR",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754609313",
            "telephone_number": "903-767-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "JOSEPH",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TX

Sources for this page

Verify at the official NPI Registry.