PHYSICIAN SERVICES OF JACKSBORO PA
NPI 1457657371
Internal Medicine in Jacksboro, TX
About Physician Services Of Jacksboro Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHYSICIAN SERVICES OF JACKSBORO PA (NPI 1457657371) is a healthcare organization registered as an internal medicine in Jacksboro, Texas and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through February 23, 2028 and lists Syed Jamal, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Physician Services Of Jacksboro Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Physician Services Of Jacksboro PA, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2253773
Physician Services Of Jacksboro, PA · Jacksboro, TXFrequently 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 Physician Services Of Jacksboro PA's NPI number?
The NPI number for Physician Services Of Jacksboro PA is 1457657371. It was assigned to this organization in the NPPES registry on February 10, 2011.
Where is Physician Services Of Jacksboro PA located?
Physician Services Of Jacksboro PA is located at 709 N 4th St, Jacksboro, TX 76458. The listed phone number is (817) 565-0922.
What is Physician Services Of Jacksboro PA's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Physician Services Of Jacksboro PA enrolled in Medicare?
Yes. Physician Services Of Jacksboro PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Physician Services Of Jacksboro PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Physician Services Of Jacksboro PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Dermatology (1) and Family Practice (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Physician Services Of Jacksboro PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2253773) is associated with this NPI, valid through February 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Physician Services Of Jacksboro PA accept?
Health plans from Blue Cross and Blue Shield of Texas list Physician Services Of Jacksboro PA 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 Physician Services Of Jacksboro PA was last updated on November 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Physician Services Of Jacksboro Pa · NPI 1457657371
Internal Medicine organization in Jacksboro, Texas. Organization record, active in the CMS NPPES registry since February 10, 2011.
## Identity
- **NPI:** 1457657371 (Entity type: Organization)
- **Enumerated:** February 10, 2011
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Syed Jamal, OWNER
## Practice location
- **Address:** 709 N 4TH ST, Jacksboro, TX 76458-1132
- **Phone:** (817) 565-0922
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Dermatology (1), Family Practice (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 23, 2011
- **Other identifiers:** Other 0036XB (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1457657371) · Data from the CMS NPPES public registry.