Individual provider Active NPI

Lydia R Essary, MD

  • Dermatopathology Physician
  • McKinney, TX
National Provider Identifier
1225018286
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
K8136 Issued in TX
Practice address
1790 N Stonebridge Dr
McKinney, TX 75071-7437
Phone
(972) 390-9002
Fax
(214) 491-3777
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X K8136 TX Primary
Dermatology Physician 207N00000X K8136 TX

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

Other identifiers 1

IdentifierTypeStateIssuer
010193700MedicaidFL

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
I20040805001470 TX Practitioner - PathologyPractitioner - Dermatology 9739150293 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew D Barrows MD PA Dermatology CurrentSince Mar 21, 2017 Accepting new patients
Ameripath 501a Corporation Dermatology Past Accepting new patients

Locations

1790 N Stonebridge Dr
McKinney, TX 75071
Phone 9723909002303

1020 W Ralph Hall Pkwy
Ste 102
Rockwall, TX 75032
Phone (970) 390-9002

Organizations & group practices 2

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1225018286",
    "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": "ESSARY",
        "first_name": "LYDIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "K8136",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "K8136",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010193700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.