COLTON PENDLEY PA-C
NPI 1124885918
Physician Assistant - Surgical in Tyler, TX

Active since February 28, 2024PECOS EnrolledAccepts Medicare Assignment
3414 GOLDEN RD, TYLER, TX 75701(903) 939-7728 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2025, Jun 4, 2025, Jun 19, 2024 (3 updates tracked since 2024).

About Colton Pendley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLTON PENDLEY PA-C (NPI 1124885918) is an individual surgical provider in Tyler, Texas, licensed in Texas (PA17878) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1124885918
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameCOLTON PENDLEYCredential: PA-C
Location Address3414 GOLDEN RDTyler, TX 75701
Mailing Address4700 Seton Center Pkwy Ste 115Austin, TX 78759-5753
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 28, 2024
Last NPPES UpdateJune 19, 20253 updates tracked since enumeration
NPPES CertifiedJune 19, 2025
NPI 1124885918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in TX · PA17878
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA17878 (TX)
3414 GOLDEN RD, Tyler, TX 75701

Secondary Practice Locations 4

Location 15345 Atlanta HwyMontgomery, AL 36109-3323 · Phone (334) 272-5820
Location 23816 N University DrNacogdoches, TX 75965 · Phone (903) 939-7728
Location 3910 E Houston StTyler, TX 75702-8369 · Phone (903) 606-8718
Location 4925 W Loop 281Longview, TX 75604 · Phone (903) 939-7728

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Colton Pendley Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971047275
PECOS Enrollment IDI20240627002087
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Baylor Scott & White Texas Spine & Joint Hospital

Acute Care Hospitals · Tyler, TX
OwnershipPhysician
CMS Certification Number450864
Location1814 Roseland BoulevardTyler, TX 75701 · Smith County
Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
3414 GOLDEN RD
TYLER, TX 75701
Pain Medicine (Interventional Pain Medicine)
3414 GOLDEN RD
TYLER, TX 75701
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
3414 GOLDEN RD
TYLER, TX 75701
Orthopaedic Surgery
3414 GOLDEN RD
TYLER, TX 75701
Physical Therapist
3414 GOLDEN RD
TYLER, TX 75701
Physical Therapist
3414 GOLDEN RD
TYLER, TX 75701
Physical Medicine & Rehabilitation
3414 GOLDEN RD
TYLER, TX 75701
Internal Medicine
3414 GOLDEN RD
TYLER, TX 75701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colton Pendley's NPI number?

The NPI number for Colton Pendley is 1124885918. It was assigned to this individual provider in the NPPES registry on February 28, 2024.

Where is Colton Pendley located?

Colton Pendley practices at 3414 Golden Rd, Tyler, TX 75701. The listed phone number is (903) 939-7728.

What is Colton Pendley's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Colton Pendley enrolled in Medicare?

Yes. Colton Pendley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Colton Pendley affiliated with any hospitals?

According to CMS data, Colton Pendley is affiliated with Ut Health East Texas Tyler Regional Hospital and Baylor Scott & White Texas Spine & Joint Hospital.

When was this NPI record last updated?

The NPPES record for Colton Pendley was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.