Active NPI
Anthony Lee Lyssy, DO
- Family Medicine Physician
- Dallas, TX
National Provider Identifier
1306071402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- N8031
- Practice address
- 5950 Berkshire LN Ste 225
Dallas, TX 75225-5857 - Phone
- (214) 550-2090
- Fax
- (888) 502-1190
- NPI assigned
- May 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | N8031 | TX | Primary |
Addresses
Primary practice location
5950 Berkshire LN Ste 225
Dallas, TX 75225-5857
Mailing address
5950 Berkshire LN Ste 225
Dallas, TX 75225-5857
Phone (214) 550-2090
Other practice location 1
8222 Douglas Ave
Suite 700
Dallas, TX 75225-5923
Phone (214) 395-3491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 25, 2018 through Apr 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1306071402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5950 BERKSHIRE LN STE 225",
"city": "DALLAS",
"state": "TX",
"postal_code": "752255857",
"telephone_number": "214-550-2090",
"fax_number": "888-502-1190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5950 BERKSHIRE LN STE 225",
"city": "DALLAS",
"state": "TX",
"postal_code": "752255857",
"telephone_number": "214-550-2090",
"fax_number": "888-502-1190"
}
],
"practiceLocations": [
{
"address_1": "8222 Douglas Ave",
"address_2": "Suite 700",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752255923",
"country_code": "US",
"telephone_number": "214-395-3491",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LYSSY",
"first_name": "ANTHONY",
"middle_name": "LEE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-19",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "N8031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.