Individual provider Active NPI

Tamara Lyn Hill, MD.

  • Dermatology Physician
  • Bartlesville, OK
National Provider Identifier
1417934852
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17349 Issued in OK
Practice address
309 SE Frank Phillips Blvd
Bartlesville, OK 74003
Phone
(918) 214-8888
Fax
(918) 214-8887
NPI assigned
Dec 28, 2005
Last updated
Sep 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17349 OK Primary

Addresses

Primary practice location

309 SE Frank Phillips Blvd
Bartlesville, OK 74003

Mailing address

309 SE Frank Phillips Blvd
Bartlesville, OK 74003
Phone (918) 214-8888

Other identifiers 1

IdentifierTypeStateIssuer
100201770AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120213000403 OK Practitioner - Dermatology 6901885961 Reassigns benefits to 1 organization
I20240229004060 TX Practitioner - Dermatology 6901885961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Brody School of Medicine at East Carolina University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

2001 Rockview Dr
Suite 101
Granbury, TX 76049-5713
Phone (682) 529-7800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1064
Removal or shaving of skin growth17
Skin biopsy353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17349OKMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Apr 1, 2024 Accepting new patients
Hill Dermatology, PLLC Dermatology Current Accepting new patients
Regional Dermatology P.C. Dermatology PastSince Apr 5, 2012 Accepting new patients
Dermatology Associates Dermatology Past Accepting new patients

Locations

309 SE Frank Phillips Blvd
Bartlesville, OK 74003
Phone (918) 214-8888

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

1314 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-7474

1314 Paluxy Rd
Ste 200
Granbury, TX 76048
Phone (817) 573-7474

2001 Rockview Dr
Granbury, TX 76049
Phone (682) 529-7800

2001 Rockview Dr
Ste 101
Granbury, TX 76049
Phone (682) 529-7800

3415 E US Highway 377
Granbury, TX 76049
Phone (682) 500-1447

603 E 6th St
Odessa, TX 79761
Phone (432) 225-9601

150 River North Blvd
Stephenville, TX 76401
Phone (254) 965-9729

160 River North Blvd
Stephenville, TX 76401
Phone (254) 965-2500

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1417934852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SE FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-214-8888",
            "fax_number": "918-214-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SE FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-214-8888",
            "fax_number": "918-214-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "TAMARA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "17349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100201770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.