Individual provider Active NPI

Dustin Max McDermott, M.D.

  • Surgery Physician
  • Longview, TX
National Provider Identifier
1154387538
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
N3172 Issued in TX
Practice address
703 E Marshall Ave
Suite 3000
Longview, TX 75601-5500
Phone
(903) 315-2762
Fax
(903) 315-2595
NPI assigned
Apr 25, 2006
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01060359A IN
Surgery Physician 208600000X N3172 TX Primary

Addresses

Primary practice location

703 E Marshall Ave
Suite 3000
Longview, TX 75601-5500

Mailing address

PO Box 4207
Longview, TX 75606-4207
Phone (903) 315-2762

Other practice location 1

705 E Marshall Ave Ste 5000
Longview, TX 75601-5660
Phone (903) 315-4400

Other practice location 2

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

Other identifiers 1

IdentifierTypeStateIssuer
P00923240OtherINRAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120521000488 TX Practitioner - General Surgery 8123166519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

700 E Marshall Ave
Christus Trinity Clinic
Longview, TX 75601-5580
Phone (903) 315-1488

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux12
Melanoma (skin cancer) excision1-10
Removal of tissue14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060359AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
Christus Good Shepherd Medical Center Past Accepting new patients

Locations

1600 Broadway Ave
Gladewater, TX 75647
Phone (903) 315-5630

703 E Marshall Ave
Ste 3000
Longview, TX 75601
Phone (903) 315-1970

705 E Marshall Ave
Ste 5000
Longview, TX 75601
Phone (903) 315-1970

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: dmcdermott149639@christushealth.direct-ci.net
  • Direct secure messaging: dustin.mcdermott@direct.myteamcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1154387538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4207",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756064207",
            "telephone_number": "903-315-2762",
            "fax_number": "903-315-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE",
            "address_2": "SUITE 3000",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015500",
            "telephone_number": "903-315-2762",
            "fax_number": "903-315-2595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Marshall Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015660",
            "country_code": "US",
            "telephone_number": "903-315-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 S Fleishel Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012041",
            "country_code": "US",
            "telephone_number": "903-606-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "DUSTIN",
        "middle_name": "MAX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01060359A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "N3172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00923240",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.