Individual provider Active NPI

Maurice G Syrquin, MD

  • Retina Specialist (Ophthalmology) Physician
  • Dallas, TX
National Provider Identifier
1376501635
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
H9162 Issued in TX
Practice address
3414 Oak Grove Ave
Dallas, TX 75204-2375
Phone
(214) 521-1153
Fax
(214) 219-3651
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X H9162 TX
Retina Specialist (Ophthalmology) Physician 207WX0107X G69442 CA
Ophthalmology Physician 207W00000X G69442 CA
Ophthalmology Physician 207W00000X 73015 MA
Retina Specialist (Ophthalmology) Physician 207WX0107X H9162 TX Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 73015 MA

Addresses

Primary practice location

3414 Oak Grove Ave
Dallas, TX 75204-2375

Mailing address

3414 Oak Grove Ave
Dallas, TX 75204-2375
Phone (214) 521-1153

Other practice location 1

1010 E Interstate 20
Arlington, TX 76018-2107
Phone (817) 417-7769

Other practice location 2

3331 Unicorn Lake Blvd
Denton, TX 76210-0102
Phone (940) 381-9100

Other practice location 3

400 W Lyndon B Johnson Fwy Ste 320
Irving, TX 75063-3717
Phone (972) 869-1242

Other identifiers 7

IdentifierTypeStateIssuer
128119807MedicaidTX
180043891OtherTXRR MEDICARE GRP CJ5857
128119804MedicaidTX
5365042OtherTXAETNA
805833OtherTXBCBS/GRP 00T587
128119806MedicaidTX
200052580AMedicaidOK

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
I20100317000811 TX Practitioner - Ophthalmology 9739090077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tufts University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Institute of Texas PAGroup PAC ID 9234160581, 4 clinicians

Practice addresses (Care Compare)

1010 E I
Suite 20
Arlington, TX 76018-2107
Phone (817) 417-7769

Hospital & facility affiliations

  • Baylor Surgical Hospital at Las Colinas Hospital, Irving, TX, CCN 450874

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Quality
98.3
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69442CAMDOphthalmology Physician
73015MAMDRetina Specialist (Ophthalmology) Physician
H9162TXMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Institute of Texas PA Ophthalmology CurrentSince Jan 1, 2010 Accepting new patients
Retina Institute of Texas PA Ophthalmology CurrentSince Jan 1, 2010 Accepting new patients
Burlingame Surgical Center, PA Past Accepting new patients
RGB Eye Associates,PA Ophthalmology Past Accepting new patients

Locations

1010 E Interstate 20
Arlington, TX 76018
Phone (817) 417-7769

3414 Oak Grove Ave
Dallas, TX 75204
Phone (214) 521-1153

3331 Unicorn Lake Blvd
Denton, TX 76210
Phone (940) 381-9100

400 W Lyndon B Johnson Fwy
Ste 320
Irving, TX 75063
Phone (972) 869-1242

1303 N Travis St
Sherman, TX 75092

Interoperability endpoints

  • Direct secure messaging: msyrquin@direct.uspi.com
  • Direct secure messaging: maurice.syrquin@riot.directbygreenway.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1376501635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-521-1153",
            "fax_number": "214-219-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-521-1153",
            "fax_number": "214-219-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 E Interstate 20",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760182107",
            "country_code": "US",
            "telephone_number": "817-417-7769",
            "fax_number": "817-417-7405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3331 Unicorn Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762100102",
            "country_code": "US",
            "telephone_number": "940-381-9100",
            "fax_number": "940-381-9106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Lyndon B Johnson Fwy Ste 320",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750633717",
            "country_code": "US",
            "telephone_number": "972-869-1242",
            "fax_number": "972-869-2921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYRQUIN",
        "first_name": "MAURICE",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "H9162",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "G69442",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G69442",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "73015",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "H9162",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MA",
            "license": "73015",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128119807",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP CJ5857",
            "identifier": "180043891",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128119804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5365042",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/GRP 00T587",
            "identifier": "805833",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128119806",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200052580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.