Individual provider Active NPI

Anthony Lee Lyssy, DO

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1306071402
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8031 Issued in TX
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

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.
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

Verify at the official NPI Registry.