Tyler Cameron Jefferson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06754 Issued in TX

Practice address

2535 W Oak St
Denton, TX 76201-2331

Phone

(940) 382-1577

Fax

(940) 387-5471

NPI assigned

Apr 19, 2006

Last updated

May 23, 2013By 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 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NM

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• La Vita Bella Home Health, LLC Home health agency, Rio Rancho, NM, CCN 327234
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
• Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjefferson283642@christushealth.direct-ci.net

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.

• St Vincent Hospital

  dba CHRISTUS St. Vincent Pediatrics

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• New Mexico Orthopaedic Associates PC

  • Orthopaedic Surgery Physician
  • Albuquerque, NM
  • NPI 1407898299
  Medicare reassignment
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Adult and Family Care

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Physicians Medical Center

  • Surgery Physician
  • Santa Fe, NM
  • NPI 1295004547
  NPD
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD (past)
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

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

• La Vita Bella Home Health LLC

  • Home Health Agency
  • Rio Rancho, NM
  • NPI 1821599226
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation
• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684

  Hospital

  Care Compare affiliation
• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1740245968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 W OAK ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012331",
            "telephone_number": "940-382-1577",
            "fax_number": "940-387-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 W OAK ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012331",
            "telephone_number": "940-382-1577",
            "fax_number": "940-387-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "TYLER",
        "middle_name": "CAMERON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06754",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06754",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00954312",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TEXAS",
            "identifier": "825N93",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - EFFECT 02/01/2011",
            "identifier": "TXB120919",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740245968",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX  02/01/2011",
            "identifier": "835N03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sushama Jasti, M.D.
• Javed M Akram MD PA (Texas Infectious Diseases Associates PA)
• Gabrielle Tolentino Javier, MS, LPC
• Kaled Jawhari, D.C.
• Madiha Jawwad, MD
• Sydney Jeffrey, LMFT
• Jelani Angels Healthcare, Inc
• Jungyu Esther Jenke, FNP
• Jennifer Polen
• Adrienne Douglas Jennings, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; 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.