Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164016663 Individual Practitioner Male Practitioner

Jason Buckaloo , PA

Physician Assistant • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Jason Buckaloo, PA is a certified Physician Assistant practicing in Tyler, TX. With approximately 3 years of clinical experience since completing medical education in 2023, Jason Buckaloo delivers high-quality medical care to the local community at 700 OLYMPIC PLAZA CIR STE 600.

Jason Buckaloo does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

700 Olympic Plaza Cir Ste 600

Tyler, TX 757011954

Telephone 9035963844
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Tyler, TX

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -14.1 yrs vs City Avg
City Avg: 17.1 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
99 Specialists

Practicing in Tyler, TX (11140 Statewide)

Telehealth Adoption Rate
6.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Buckaloo (3 Years) 3 Yrs
Tyler Specialty Average (17.1 Years) 17.1 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-06-16
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA19895

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.

Physician Assistant - Surgical

NUCC Taxonomy Code: 363AS0400X

State License TX PA19895

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
124305100 (FL)
Commercial Insurance / Payer ID State Medical License
PAT9117647 (FL)
Commercial Insurance / Payer ID Pa License
PA19895 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Christina Tinkler , PA

Physician Assistant

NPI 1073515169

Physician Assistant

Dr. Clayton Hodges , MD

Orthopaedic Surgery

NPI 1154680486

Doctor of Medicine (M.D.)

Dr. Alireza Behboudi , DO

Orthopaedic Surgery

NPI 1245302819

Doctor of Osteopathic Medicine (D.O.)

Dr. Dennis Devinney , DO

Orthopaedic Surgery

NPI 1457398935

Doctor of Osteopathic Medicine (D.O.)

Kristin Meharry , FNP-C

Nurse Practitioner - Family

NPI 1487024709

Family Nurse Practitioner (Certified)

Dr. Anthony Rhorer , MD

Orthopaedic Surgery - Orthopaedic Trauma

NPI 1548265606

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Practice Location June 16, 2026

Registered at 700 OLYMPIC PLAZA CIR STE 600, TYLER, TX 757011954 (Tel: 9035963844)

📍
Updated Business Mailing Address June 16, 2026

Registered at 700 OLYMPIC PLAZA CIR STE 600, TYLER, TX 757011954 (Tel: 9035963844)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2026

Physician Assistant (License #PA19895 in TX)

📍
Updated Practice Location November 18, 2024

Registered at 13800 VETERANS WAY, ORLANDO, FL 328277401 (Tel: 4076310100)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 18, 2024

Physician Assistant (License #PA9117647 in FL)

📍
Updated Practice Location August 29, 2023

Registered at 7780 LAKE UNDERHILL RD STE 111, ORLANDO, FL 328228218 (Tel: 9702481527)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2023

Physician Assistant (License #PAT9117647 in FL)

📍
Updated Practice Location June 14, 2023

Registered at 13800 VETERANS WAY, ORLANDO, FL 328277401 (Tel: 4076310100)

📍
Updated Business Mailing Address June 14, 2023

Registered at 13800 VETERANS WAY, ORLANDO, FL 328277401 (Tel: 4076310100)

👤
Provider Name / Credentials Updated June 14, 2023

Recorded as JASON BUCKALOO, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 14, 2023

Physician Assistant

NPI Profile Active February 24, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location February 24, 2021

Registered at 615 BALANCED ROCK WAY APT 137, GRAND JUNCTION, CO 815051608 (Tel: 8329786831)

📍
Updated Business Mailing Address February 24, 2021

Registered at 615 BALANCED ROCK WAY APT 137, GRAND JUNCTION, CO 815051608 (Tel: 8329786831)

👤
Provider Name / Credentials Updated February 24, 2021

Recorded as JASON BUCKALOO, PA-S

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 24, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164016663
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 24, 2021
Last Update: June 16, 2026
Sole Proprietor: Yes

Mailing Address

700 Olympic Plaza Cir Ste 600

Tyler, TX 757011954

Phone: 9035963844

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.