Individual provider Active NPI

Michelle Lyn, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Houston, TX
National Provider Identifier
1285714683
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
J7059 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2303
Phone
(832) 824-5497
Fax
(832) 825-5424
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X J7059 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2303

Mailing address

6621 Fannin St
Houston, TX 77030-2303
Phone (832) 824-5497

Other identifiers 1

IdentifierTypeStateIssuer
133118301MedicaidTX

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
I20110315000814 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6507048352 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J7059TXMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Texas Children's Physician Group CurrentSince Jul 4, 2024 Accepting new patients
Texas Children's Hospital Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

Interoperability endpoints

  • Direct secure messaging: mlyn5992@prddirect.texaschildrens.org

Organizations & group practices 4

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1285714683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5497",
            "fax_number": "832-825-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5497",
            "fax_number": "832-825-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYN",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "J7059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133118301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.