Individual provider Active NPI

Rebecca Lynne Eary, DO

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1396972865
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S2576 Issued in TX
Practice address
5939 Harry Hines Blvd Ste 303
Dallas, TX 75390-2566
Phone
(214) 645-3900
Fax
(214) 645-3901
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125056753 IL
Family Medicine Physician 207Q00000X S2576 TX Primary

Addresses

Primary practice location

5939 Harry Hines Blvd Ste 303
Dallas, TX 75390-2566

Mailing address

1 Erie CT
Suite 6160
Oak Park, IL 60302-2566
Phone (708) 763-1490

Other identifiers 3

IdentifierTypeStateIssuer
036-130684OtherILIL MEDICAL LICENSE
036-130684MedicaidIL
S2576OtherTXTEXAS MEDICAL LICENSE

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
I20190910001015 TX Practitioner - Family Practice 1951552785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

3030 Waterview Pkwy
Richardson, TX 75080-1400
Phone (972) 669-7070

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056753ILMDFamily Medicine Physician
S2576TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2019 Accepting new patients
Illinois Pathology Associates, LTD. Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Nov 22, 2020 Accepting new patients

Locations

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

5939 Harry Hines Blvd
Ste 303
Dallas, TX 75235
Phone (214) 645-3900

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

400 W Magnolia Ave
Ft Worth, TX 76104
Phone (817) 288-9700

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: rebecca.eary.1@18564.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1396972865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ERIE CT",
            "address_2": "SUITE 6160",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022566",
            "telephone_number": "708-763-1490",
            "fax_number": "708-763-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD STE 303",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753902566",
            "telephone_number": "214-645-3900",
            "fax_number": "214-645-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARY",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125056753",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S2576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL MEDICAL LICENSE",
            "identifier": "036-130684",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-130684",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "S2576",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.