Individual provider Active NPI

Sydney Marvin, PA-C

  • Physician Assistant
  • McKinney, TX
National Provider Identifier
1124716568
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1790 N Stonebridge Dr
McKinney, TX 75071-7437
Phone
(972) 390-9002
Fax
(214) 491-3777
NPI assigned
Apr 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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 Primary

Addresses

Primary practice location

1790 N Stonebridge Dr
McKinney, TX 75071-7437

Mailing address

1790 N Stonebridge Dr
McKinney, TX 75071-7437
Phone (972) 390-9002

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
I20230907002095 TX Practitioner - Physician Assistant 4587028667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

2801 S Hulen St
400 U.S. Dermatology Partners
Fort Worth, TX 76109-1528
Phone (817) 921-2838

Merit-based Incentive Payment System (MIPS)

Final score
76.77 of 100Reported as group
Quality
48.81
Promoting interoperability
100
Improvement activities
40
Cost
73.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. CurrentSince Jan 20, 2026 Accepting new patients

Locations

801 Road To Six Flags W
Ste 139
Arlington, TX 76012
Phone (817) 265-1356

2801 S Hulen St
Ste 400
Ft Worth, TX 76109
Phone (817) 921-2838

2321 Ira E Woods Ave
Ste 180
Grapevine, TX 76051
Phone (817) 329-2263

Organizations & group practices 1

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1124716568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N STONEBRIDGE DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717437",
            "telephone_number": "972-390-9002",
            "fax_number": "214-491-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N STONEBRIDGE DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717437",
            "telephone_number": "972-390-9002",
            "fax_number": "214-491-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "SYDNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.