Alyssa Nicole Dejong, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA15009 Issued in TX

Practice address

561 N Graham St Unit 101
Stephenville, TX 76401-3555

Phone

(254) 965-2663

Fax

(254) 968-7979

NPI assigned

Aug 10, 2020

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

Other names 1

• Alyssa Nicole Horn Former name

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cross Timbers OrthopaedicsGroup PAC ID 0345235248, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Cross Timbers Orthopaedics

  dba Cross Timbers Orthopaedics & Sports Medicine

  • Medical Specialty Clinic/Center
  • Stephenville, TX
  • NPI 1699870808
  Medicare reassignment Care Compare group
• Cross Timbers Imaging

  • Radiology Clinic/Center
  • Stephenville, TX
  • NPI 1043648215
  NPD (past)

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1720699242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 N GRAHAM ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013548",
            "telephone_number": "254-965-2663",
            "fax_number": "254-968-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 N GRAHAM ST UNIT 101",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013555",
            "telephone_number": "254-965-2663",
            "fax_number": "254-968-7979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 E Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Whitney",
            "state": "TX",
            "postal_code": "766922398",
            "country_code": "US",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA15009",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "HORN",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• DCS Medical PA (Integrity Urgent Care)
• Alexis De Los Santos I
• Darin L Deaton, DPT
• Leah Baili Deaver, COTA
• Dawn Degreve, CCC-SLP
• Shawnte Larae Deyon, SLP
• Stephanie Diaz, PT
• Sue Dickerson, SLP
• Alliyah Dillard
• Paul Dillard

• Medical Physician Assistant in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.