Individual provider Active NPI

Cameron Caleb Chin, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1912474495
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12394 Issued in TX
Practice address
508 S Adams St Ste 100
Fort Worth, TX 76104-2151
Phone
(173) 325-0998
Fax
(817) 332-9093
NPI assigned
Nov 1, 2018
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 PA12394 TX Primary

Addresses

Primary practice location

508 S Adams St Ste 100
Fort Worth, TX 76104-2151

Mailing address

1000 W Cannon St
Fort Worth, TX 76104-3029
Phone (817) 725-7900

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
I20190220001010 TX Practitioner - Physician Assistant 6901144716 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA12394TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ai Interventional LLC PastSince Oct 22, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cameron.chin@hca7.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1912474495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043029",
            "telephone_number": "817-725-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S ADAMS ST STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042151",
            "telephone_number": "173-325-0998",
            "fax_number": "817-332-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "CAMERON",
        "middle_name": "CALEB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.