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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JASON BUCKALOO PA
NPI 1164016663
Physician Assistant in Tyler, TX

Active since February 24, 2021PECOS Enrolled
700 OLYMPIC PLAZA CIR STE 600, TYLER, TX 75701(903) 596-3844 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 18, 2024, Aug 29, 2023, Aug 21, 2023 and 2 more (5 updates tracked since 2021).

About Jason Buckaloo Pa NPPES

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

JASON BUCKALOO PA (NPI 1164016663) is an individual physician assistant in Tyler, Texas, licensed in Texas (PA19895) and active in the NPI registry since February 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1164016663
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJASON BUCKALOOCredential: PA
Location Address700 OLYMPIC PLAZA CIR STE 600Tyler, TX 75701-1954
Mailing Address700 Olympic Plaza Cir Ste 600Tyler, TX 75701-1954 · (903) 596-3844
Phone(903) 596-3844
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 24, 2021
Last NPPES UpdateJune 16, 20265 updates tracked since enumeration
NPPES CertifiedJune 16, 2026
✔ NPI 1164016663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA19895
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA19895 (TX)
700 OLYMPIC PLAZA CIR STE 600, Tyler, TX 75701
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Other Identifiers 3

OtherPAT9117647FL · State Medical License
Medicaid124305100FL
OtherPA19895TX · Pa License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason Buckaloo Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284079922
PECOS Enrollment IDI20260311003224
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

DAVID ROBERT DEWALCH PA-C
Physician Assistant
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3488
EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES
Durable Medical Equipment & Medical Supplies
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844
MRS. CHRISTINA ANN TINKLER P.A.
Physician Assistant
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844
DR. CLAYTON THOMAS HODGES M.D.
Orthopaedic Surgery
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844
ALIREZA BEHBOUDI D.O.
Orthopaedic Surgery
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844
ETMC FIRST PHYSICIANS CLINIC
Nurse Practitioner (Family)
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844
ADRIAN LEE BUTLER MD
Orthopaedic Surgery (Hand Surgery)
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3488
ANTHONY S RHORER MD
Orthopaedic Surgery (Orthopaedic Trauma)
700 OLYMPIC PLAZA CIR STE 600
TYLER, TX 75701
Smith County (903) 596-3844

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 Jason Buckaloo's NPI number?

The NPI number for Jason Buckaloo is 1164016663. It was assigned to this individual provider in the NPPES registry on February 24, 2021.

Where is Jason Buckaloo located?

Jason Buckaloo practices at 700 Olympic Plaza Cir Ste 600, Tyler, TX 75701. The listed phone number is (903) 596-3844.

What is Jason Buckaloo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jason Buckaloo enrolled in Medicare?

Yes. Jason Buckaloo is registered in the Medicare PECOS enrollment system.

What insurance does Jason Buckaloo accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama and Molina Healthcare list Jason Buckaloo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jason Buckaloo was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 54 days 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.