Active NPI
Niyomi De Silva, M.D.
- Family Medicine Physician
- Grand Prairie, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- T3609
- Practice address
- 4927 Lake Ridge Pkwy Ste 100
Grand Prairie, TX 75052-3060 - Phone
- (469) 506-1671
- NPI assigned
- Jul 28, 2009
- Last updated
- Mar 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 125056535 | IL | |
| Family Medicine Physician | 207Q00000X | 0101253694 | VA | |
| Family Medicine Physician | 207Q00000X | 47283 | TX | |
| Family Medicine Physician | 207Q00000X | ME122692 | FL | |
| Family Medicine Physician | 207Q00000X | T3609 | TX | Primary |
Addresses
Primary practice location
4927 Lake Ridge Pkwy Ste 100
Grand Prairie, TX 75052-3060
Mailing address
4401 Coit Rd Ste 409
Frisco, TX 75035-0519
Phone (469) 800-4130
Other practice location 1
1201 1st St S Ste 100A
Winter Haven, FL 33880-3904
Phone (863) 280-6080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014452700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4401 Coit Rd
Suite 409
Frisco, TX 75035-0519
Phone (469) 800-4130
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125056535 | IL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthtexas Provider Network | Family Medicine | Current | Accepting new patients |
| Healthtexas Provider Network | Current | Accepting new patients | |
| Hospital Physician Services of Florida PA | Family Medicine | Current | Accepting new patients |
| Healthtexas Provider Network | Family Medicine | Current | Accepting new patients |
Locations
8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212
200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652
4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745
4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665
7777 Forest Ln
Ste C300
Dallas, TX 75230
Phone (972) 566-6000
900 Jerome St
Ste 204
Fort Worth, TX 76104
Phone (817) 885-7827
4401 Coit Rd
Ste 409
Frisco, TX 75035
Phone (469) 800-4130
4927 Lake Ridge Pkwy
Ste 100
Grand Prairie, TX 75052
Phone (913) 669-3321
821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200
Interoperability endpoints
- ndesilva1143371@direct.sw.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Dallas, TX
- NPI 1760488936
-
- Hospitalist Physician
- Pensacola, FL
- NPI 1558718635
Family Medicine
-
- Family Medicine Physician
- Plano, TX
- NPI 1003811639
-
dba Symmetry Anesthesia
- Anesthesiology Physician
- Lakeway, TX
- NPI 1104714583
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1447250253
-
dba Baylor Institute for Rehabilitation
- Rehabilitation Hospital
- Dallas, TX
- NPI 1538465901
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1447481213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 COIT RD STE 409",
"city": "FRISCO",
"state": "TX",
"postal_code": "750350519",
"telephone_number": "469-800-4130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4927 LAKE RIDGE PKWY STE 100",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750523060",
"telephone_number": "469-506-1671"
}
],
"practiceLocations": [
{
"address_1": "1201 1st St S Ste 100A",
"address_purpose": "LOCATION",
"city": "Winter Haven",
"state": "FL",
"postal_code": "338803904",
"country_code": "US",
"telephone_number": "863-280-6080",
"fax_number": "863-229-7587",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE SILVA",
"first_name": "NIYOMI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-28",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "125056535",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101253694",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "47283",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME122692",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "T3609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014452700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.