Individual provider Active NPI

Lynne Jeanine Roberts, M.D.

  • Dermatology Physician
  • Dallas, TX
National Provider Identifier
1023134756
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
F8647 Issued in TX
Practice address
8144 Walnut Hill LN
Ste 360
Dallas, TX 75231-4324
Phone
(469) 232-9300
Fax
(469) 232-9850
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F8647 TX Primary
Dermatology Physician 207N00000X 01028675A IN

Addresses

Primary practice location

8144 Walnut Hill LN
Ste 360
Dallas, TX 75231-4324

Mailing address

8144 Walnut Hill LN
Ste 360
Dallas, TX 75231-4324
Phone (469) 232-9300

Other identifiers 3

IdentifierTypeStateIssuer
415509OtherTXPHCS
00F78BOtherTXBCBS
4111259OtherTXAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01028675AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abksw Preferred Health Partners, PLLC PastSince May 1, 2023 Accepting new patients
Lynne J. Roberts, M.D., P. a. Dermatology PastSince Jan 1, 1990 Accepting new patients
Abksw Preferred Health Specialty Partners PLLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1023134756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8144 WALNUT HILL LN",
            "address_2": "STE 360",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314324",
            "telephone_number": "469-232-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8144 WALNUT HILL LN",
            "address_2": "STE 360",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314324",
            "telephone_number": "469-232-9300",
            "fax_number": "469-232-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LYNNE",
        "middle_name": "JEANINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F8647",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01028675A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "415509",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00F78B",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4111259",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.