Jared Daniel Jacques, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17791 Issued in TX

Practice address

627 Turtle Creek Dr
Tyler, TX 75701-1832

Phone

(903) 593-2539

NPI assigned

Jan 29, 2024

Last updated

Mar 18, 2024By the provider in NPPES

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Baylor Scott & White Texas Spine & Joint Hospital Hospital, Tyler, TX, CCN 450864
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacques1005210@ahs.direct-ci.com

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.

• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975
  Medicare reassignment Care Compare group NPD
• Clinical Care in Radiology

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1578331393
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Hopkins Health Alliance

  dba Christus Mother Frances - Sulphur Springs

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Texas Spine and Joint Hospital, LLC

  dba Baylor Scott & White TX Spine & Joint Hos Imaging Ctr

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1942292255
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1720840218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761043194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011832",
            "telephone_number": "903-593-2539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "816 W Cannon St",
            "address_purpose": "LOCATION",
            "city": "Ft Worth",
            "state": "TX",
            "postal_code": "761043194",
            "country_code": "US",
            "telephone_number": "817-321-0499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "JARED",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Karol Jackson, CFNP
• Royce Eugene Jackson, RPH
• Zha'Nae L Jackson
• Gayla Jacobs, LPC-S
• Alexander Paul Jacobsen, DO
• Daisy Jacquez, PHARMD
• Abeer B Jafry
• Rabab Zehra Jafry, MD
• Milan Jaiswal
• Charlette Laree Jallow

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.