Jacqueline Harris, P.A.-C.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA03245 Issued in TX

Practice address

800 5TH Ave Ste 300
Fort Worth, TX 76104-7303

Phone

(817) 878-5300

Fax

(817) 878-5321

NPI assigned

Jul 18, 2006

Last updated

Sep 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jharris1122478@direct.texashealth.org

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.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD
• TMH Physicians and Surgeons, PLLC

  dba TMHPO Institute for Reconstructive Surgery

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
  • NPI 1669894796
  Medicare reassignment
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• TMH Physician Organization

  dba TMHPO Institute for Reconstructive Surgery

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
  • NPI 1285684431
  NPD (past)

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

• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1821016403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047303",
            "telephone_number": "817-878-5300",
            "fax_number": "817-878-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047303",
            "telephone_number": "817-878-5300",
            "fax_number": "817-878-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACQUELINE",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1821016403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily M Harris, AUD
• Gerald Ray Harris, DO
• Hunter Harris, PA-C
• Jackalyn Michelle Harris
• Jaclyn Liewer Harris, APRN
• Jami Harris
• Jennifer Harris
• John D. Harris, CRNA
• John Timothy Harris I, M.A.
• Jordan Harris, PT, DPT

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.