Jaison Ninan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14759 Issued in TX

Practice address

800 Medical Center Dr Ste C
Decatur, TX 76234-3844

Phone

(940) 626-2110

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Christine Holland MD PA

  • Family Medicine Physician
  • Decatur, TX
  • NPI 1962677740
  Medicare reassignment
• Legacy Urgent Care, PA

  • Urgent Care Clinic/Center
  • Frisco, TX
  • NPI 1568622272
  Medicare reassignment
• Texas Center for Urology LLP

  • Urology Physician
  • Fort Worth, TX
  • NPI 1366710196
  Medicare reassignment
• Southwest Texas Two Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1659950475
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1689244675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "address_2": "STE C",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343844",
            "telephone_number": "940-626-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR STE C",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343844",
            "telephone_number": "940-626-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINAN",
        "first_name": "JAISON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Naeem, M.D.
• Neurospectrum, LTD.
• Neurospectrum, LTD.
• New Crescent Hospice, LLC
• Faryal Niazi, M.D.
• Tyler James Noble, CPHT
• Robin Nobles, LPC-A
• North Central Texas Advanced Neurology PA
• North Central Texas Family Medicine PA
• North Central Texas Foot & Ankle, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.