JACK D RUNYAN PA, PHD
NPI 1245476282
Physician Assistant - Medical in Fairfield, TX

Q: What is Jack Runyan's NPI number?

The NPI number for Jack Runyan is 1245476282. It was assigned to this individual provider in the NPPES registry on December 22, 2008.

Q: What is Jack Runyan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jack Runyan was last updated on August 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.

Active since December 22, 2008PECOS Enrolled

734 W COMMERCE ST, FAIRFIELD, TX 75840(956) 572-4000 Get Directions Write a Review

NPPES record last updated: August 7, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack D Runyan Pa, Phd NPPES

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

JACK D RUNYAN PA, PHD (NPI 1245476282) is an individual medical provider in Fairfield, Texas, licensed in Texas (PA 01154) and active in the NPI registry since December 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245476282

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJACK D RUNYANCredential: PA, PHD

Location Address734 W COMMERCE STFairfield, TX 75840

Mailing Address734 W Commerce StFairfield, TX 75840-1428 · (903) 389-2181 · Fax (903) 389-0901

Phone(956) 572-4000

Sole ProprietorYes

Enumeration DateDecember 22, 2008

Last NPPES UpdateAugust 7, 2018

✔ NPI 1245476282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in TX · PA 01154

734 W COMMERCE ST, Fairfield, TX 75840

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack D Runyan Pa, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%3,072 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

5%256 patients1/55-star benchmark: 88%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 8

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

FAIRFIELD HOSPITAL DISTRICT

Clinic/Center (Rural Health)

734 W COMMERCE ST, SUITE C
FAIRFIELD, TX 75840

Freestone County (903) 389-2121

DR. DARRYL WHITE M.D.

Family Medicine

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (956) 389-2181

KAYLA SIERRA FARMER APRN, FNP-S

Nurse Practitioner (Family)

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (903) 389-2181

STACY ANN GALLEGOS FNP

Nurse Practitioner (Family)

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (903) 389-2181

EAST TEXAS MEDICAL CENTER HOME SERVICES

Hospice Care, Community Based

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (903) 389-3504

KATRINA LOGAN FNP-BC

Nurse Practitioner (Family)

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (903) 389-2181

EAST TEXAS MEDICAL CENTER HOME SERVICES

Home Health

734 W COMMERCE ST, SUITE B
FAIRFIELD, TX 75840

Freestone County (903) 389-3468

MARK WAWERU M.D.

Family Medicine

734 W COMMERCE ST
FAIRFIELD, TX 75840

Freestone County (903) 389-0926

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 Jack Runyan's NPI number?

The NPI number for Jack Runyan is 1245476282. It was assigned to this individual provider in the NPPES registry on December 22, 2008.

Where is Jack Runyan located?

Jack Runyan practices at 734 W Commerce St, Fairfield, TX 75840. The listed phone number is (956) 572-4000.

What is Jack Runyan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jack Runyan enrolled in Medicare?

Yes. Jack Runyan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Runyan was last updated on August 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.