Individual provider Active NPI

Amy Alexander Rydin, M.D.

  • Pediatric Endocrinology Physician
  • Austin, TX
National Provider Identifier
1417341074
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
T0332 Issued in TX
Practice address
1301 Barbara Jordan Blvd Ste C
Austin, TX 78723-3077
Phone
(512) 628-1830
Fax
(512) 628-1831
NPI assigned
Mar 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125067619 IL
Pediatric Endocrinology Physician 2080P0205X DR0060417 CO
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X T0332 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd Ste C
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd Ste C
Austin, TX 78723-3077
Phone (512) 628-1830

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045
Phone (832) 677-1955

Other practice location 2

225 E Chicago Ave
#18
Chicago, IL 60611-2991
Phone (312) 227-3220

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
I20211019002251 TX Practitioner - Pediatric MedicinePractitioner - Endocrinology 1759638018 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125067619ILMDPediatrics Physician
T0332TXMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group Pediatrics CurrentSince Aug 16, 2021 Accepting new patients
Dell Children's Medical Group Pediatrics Current Accepting new patients
Dell Children's Medical Group CurrentSince Aug 16, 2021 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1301 Barbara Jordan Blvd
Ste C
Austin, TX 78723
Phone (512) 628-1830

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: amy.rydin.1@8363.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1417341074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1830",
            "fax_number": "512-628-1831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80045",
            "country_code": "US",
            "telephone_number": "832-677-1955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 E Chicago Ave",
            "address_2": "#18",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "312-227-3220",
            "fax_number": "312-227-9637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYDIN",
        "first_name": "AMY",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125067619",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CO",
            "license": "DR0060417",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "T0332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.