Individual provider Active NPI

Angela Harden, PA

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1760680953
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05307 Issued in TX
Practice address
1040 S Fleishel Ave
Tyler, TX 75701-2031
Phone
(903) 533-8702
Fax
(903) 533-8720
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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 PA05307 TX Primary

Addresses

Primary practice location

1040 S Fleishel Ave
Tyler, TX 75701-2031

Mailing address

1040 S Fleishel Ave
Tyler, TX 75701-2031
Phone (903) 533-8702

Other practice location 1

102 S Main St
Grapeland, TX 75844-2448
Phone (936) 687-2041

Other practice location 2

313 W Parker St
Elkhart, TX 75839-7612
Phone (903) 764-5626

Other practice location 3

3201 S Loop 256 Ste 200
Palestine, TX 75801-6913
Phone (903) 723-0330

Other practice location 4

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 586-5678

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
I20110727000338 TX Practitioner - Physician Assistant 9830287564 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mother Frances Hospital JacksonvilleGroup PAC ID 5597751024, 30 clinicians

Practice addresses (Care Compare)

2010 S Jackson St
Christus Mother Frances Hospital Jacksonvil
Jacksonville, TX 75766-5822
Phone (903) 541-4548

2026 S Jackson St
Jacksonville, TX 75766-5822

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Palestine, TX, CCN 678197
  • Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA05307TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jun 5, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 5, 2023 Accepting new patients
Momentum Urgent Care, PLLC PastSince Aug 26, 2013 Accepting new patients

Locations

313 W Parker St
Elkhart, TX 75839
Phone (903) 764-5626

102 S Main St
Grapeland, TX 75844
Phone (936) 687-2041

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3201 S Loop 256
Ste 200
Palestine, TX 75801
Phone (903) 723-0330

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: aharden308118@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1760680953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012031",
            "telephone_number": "903-533-8702",
            "fax_number": "903-533-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012031",
            "telephone_number": "903-533-8702",
            "fax_number": "903-533-8720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S Main St",
            "address_purpose": "LOCATION",
            "city": "Grapeland",
            "state": "TX",
            "postal_code": "758442448",
            "country_code": "US",
            "telephone_number": "936-687-2041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 W Parker St",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "TX",
            "postal_code": "758397612",
            "country_code": "US",
            "telephone_number": "903-764-5626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 S Loop 256 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758016913",
            "country_code": "US",
            "telephone_number": "903-723-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2026 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757665822",
            "country_code": "US",
            "telephone_number": "903-586-5678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "ANGELA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.