Individual provider Active NPI

Lynn Azuma, M.D.

  • Pediatrics Physician
  • Round Rock, TX
National Provider Identifier
1295782043
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M6508 Issued in TX
Practice address
425 University Blvd
Suite 130
Round Rock, TX 78665-1053
Phone
(512) 509-0200
Fax
(512) 509-3514
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 233324 NY
Pediatrics Physician 208000000X M6508 TX Primary

Addresses

Primary practice location

425 University Blvd
Suite 130
Round Rock, TX 78665-1053

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 2

IdentifierTypeStateIssuer
02633585MedicaidNY
190139901MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lazuma10938@direct.sw.org Direct

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
I20070919000480 TX Practitioner - Pediatric Medicine 0143314351 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233324NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott and White Clinic Pediatrics CurrentSince Dec 26, 2010 Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Dec 26, 2010 Accepting new patients
Scott & White Clinic Pediatrics Current Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

425 University Blvd
Ste 130
Round Rock, TX 78665
Phone (512) 509-5437

425 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

Interoperability endpoints

  • Direct secure messaging: lazuma10938@direct.sw.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1295782043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "address_2": "SUITE 130",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651053",
            "telephone_number": "512-509-0200",
            "fax_number": "512-509-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZUMA",
        "first_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "233324",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M6508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02633585",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190139901",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lazuma10938@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "425 University Blvd",
            "address_2": "Suite 130",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.