JONATHAN DAVID DICKSON (PA-C) – Physician Assistant, NPI 1487110474

JONATHAN DAVID DICKSON (PA-C) is a healthcare provider. based in Fort worth, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA13777 (TX). The NPI Number for JONATHAN DAVID DICKSON (PA-C) is 1487110474

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN DAVID DICKSON (PA-C)
NPI
1487110474
Phone
(817) 321-0404
Address
816 W CANNON ST
Enumeration Date
14 February 2019
Last Update Date
1 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4797187546
Graduation Year
2019 (7 years ago)
PAC ID
3072923275
Group Practice PAC ID
2961588900
Professional Enrollment ID
I20230410000476
Address ID
AR727034969FA1444XSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:7State licenses:2Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Loading map...

Provider Addresses for JONATHAN DAVID DICKSON (PA-C)

  • 816 W CANNON ST

    FORT WORTH, TX 761043146

    Phone: (817) 321-0404

    Type: Mailing

  • 627, Turtle Creek Drive, Tyler, Smith County, Texas, 75701, United States

    TYLER, TX 757011832

    Phone: (903) 593-2539

    Type: Location

  • 1444 E STEARNS ST STE 11

    FAYETTEVILLE, AR 727034969

    Phone: (479) 718-7546

    Fax: (479) 966-4979

    Type: Mailing

  • 2002, Magnolia Drive, Tyler, Smith County, Texas, 75701, United States

    TYLER, TX 757014534

    Phone: (903) 530-9867

    Type: Mailing

  • 492 Foster Chapel Rd

    Searcy, AR 721439605

    Phone: (903) 530-7986

    Type: Location

  • 627 Turtle Creek Dr

    Tyler, TX 757011832

    Phone: (903) 593-2539

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 26 Open Payments records for all available years, with a total value of $662.

Total Amount is formed as General ($662) + Research ($0) + Ownership ($0) = $662.

Last reported payment date: 2024-12-08 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($162).

Total Amount

$662

General + Research + Ownership

Payments

26

Total payment records

General Amount

$662

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-08

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-04-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230410000476IPhysician AssistantARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths40089$0
99213Established patient office or other outpatient visit, 20-29 minutes156136$0
17000Destruction of precancer skin growth, 1 growth134121$0
99203New patient office or other outpatient visit, 30-44 minutes131131$0
17110Destruction of skin growth, 1-14 growths9077$0
View full utilization report →

Insurance plans in this area (ZIP 76104)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961588900View full group profile
NameSpecialtyState
-AR
Physician AssistantAR
D E R M A T O L O G YAZ
Physician AssistantAR
D E R M A T O L O G YTX
D E R M A T O L O G YAR
Physician AssistantOK

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify JONATHAN DAVID DICKSON (PA-C) with an NPI only?
You can start verification with NPI 1487110474 for JONATHAN DAVID DICKSON (PA-C), then check state licensing separately.
Does the file indicate JONATHAN DAVID DICKSON (PA-C) is practicing under active NPI?
Directory data currently reports JONATHAN DAVID DICKSON (PA-C) as active.
What healthcare role does JONATHAN DAVID DICKSON (PA-C) hold?
Scheduling teams often label JONATHAN DAVID DICKSON (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is JONATHAN DAVID DICKSON (PA-C) based?
JONATHAN DAVID DICKSON (PA-C) is tied to Fort Worth, Texas in the data we show; additional addresses may exist on the full record.
Why does JONATHAN DAVID DICKSON (PA-C) have multiple addresses?
7 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

Similar Providers

PAMELA JEAN PLAKE (P.A.-C)

Physician Assistant
909 NINTH AVE SUITE 300
NPI: 1023018645

MELISSA NEAL WRIGHT (PA-C)

Physician Assistant
1101, South Main Street, Fort Worth, Tarrant County, Texas, 76104, United States
NPI: 1215937651
1971 E 4TH ST STE 200
NPI: 1932109204
3025 N Tarrant Pkwy # 170
NPI: 1295736973

LUCIANA ROCHETTI (PA-C)

Physician Assistant
FT, R 42, Zieglöde, Frauenzell, Wiesent, Wörth an der Donau (VGem), Landkreis Regensburg, Bavaria, 93109, Germany
NPI: 1497747653

LAURA JILL JONES (PA-C)

Physician Assistant
2100 ELDORADO PKWY
NPI: 1881686939
2400 Mall Cir
NPI: 1124013198