Individual provider Active NPI

Sydnee A Homeyer, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1053972471
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12861 Issued in TX
Practice address
4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318
Phone
(214) 388-0202
Fax
(214) 388-0214
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12861 TX Primary

Addresses

Primary practice location

4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318

Mailing address

4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318
Phone (214) 388-0202

Other identifiers 1

IdentifierTypeStateIssuer
PA12861OtherTXTMB LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201001181 TX Practitioner - Physician Assistant 4688027022 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CD Urgent Care Center 5, PLLCGroup PAC ID 5698070928, 17 clinicians
Citydoc Urgent Care Center 2, PLLCGroup PAC ID 9638354103, 20 clinicians

Practice addresses (Care Compare)

3116 W 6TH St
Suite 100
Fort Worth, TX 76107-2731
Phone (817) 984-8687

5301 W Lovers Lane
Suite 109
Dallas, TX 75209-4244
Phone (214) 352-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA12861TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reclaim Physicians Medical Group Inc Past Accepting new patients
Dallas Healthcare for Children Past Accepting new patients
Paul Phillips III, M.D., P.a. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12984/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sydnee.homeyer.pa.1@12984.direct.athenahealth.com

Organizations & group practices 7

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1053972471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD STE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-0202",
            "fax_number": "214-388-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD STE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-0202",
            "fax_number": "214-388-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMEYER",
        "first_name": "SYDNEE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMB LICENSE",
            "identifier": "PA12861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.