Individual provider Active NPI

Shauna Lyn, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1437214624
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K7449 Issued in TX
Practice address
418 N Loop 1604 W
San Antonio, TX 78232-1456
Phone
(210) 595-1019
Fax
(210) 251-3194
NPI assigned
Dec 27, 2006
Last updated
Jan 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 058616 GA
Family Medicine Physician 207Q00000X K7449 TX Primary
Urology Physician 208800000X K7449 TX

Addresses

Primary practice location

418 N Loop 1604 W
San Antonio, TX 78232-1456

Mailing address

418 N Loop 1604 W
San Antonio, TX 78232-1456
Phone (210) 595-1019

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
I20150622000363 TX Practitioner - Preventive Medicine 7214248038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
University of Texas Medical School at San Antonio, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

12702 Toepperwein Rd
Suite 120
Live Oak, TX 78233-3208
Phone (210) 653-4420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
058616GAMDSpecialist
K7449TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bernice Gonzalez, MD, PA CurrentSince Jan 15, 2019 Accepting new patients
American Current Care, P.a. Current Accepting new patients
American Current Care PA CurrentSince Jul 6, 2020 Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

12702 Toepperwein Rd
Ste 120
Live Oak, TX 78233
Phone (210) 637-5742

2520 Broadway St
Ste 100
San Antonio, TX 78215
Phone (210) 595-1019

418 N Loop 1604 W
San Antonio, TX 78232
Phone (210) 595-1019

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12437/brand/1/csg/1/fhir/r4

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, 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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1437214624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N LOOP 1604 W",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321456",
            "telephone_number": "210-595-1019",
            "fax_number": "210-251-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N LOOP 1604 W",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321456",
            "telephone_number": "210-595-1019",
            "fax_number": "210-251-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYN",
        "first_name": "SHAUNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "058616",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7449",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "K7449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.