Individual provider Active NPI

Gregory Walker, M.D., M.B.A.

  • Dermatology Physician
  • Waco, TX
National Provider Identifier
1487074084
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R5338 Issued in TX
Practice address
300 Richland West Cir Ste 2C
Waco, TX 76712-7935
Phone
(254) 340-6000
Fax
(254) 340-6010
NPI assigned
Apr 22, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas Tech University Health Science Center School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) Inc 169 clinicians

Practice addresses (Care Compare)

300 Richland W Cir
2C U.S. Dermatology Partners
Waco, TX 76712-7935
Phone (254) 340-6000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision95
Removal of skin lesions1189
Removal of skin cancer378
Removal or shaving of skin growth1-10
Skin biopsy308

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20180516001339 TX Practitioner - Dermatology 4587951298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R5338TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Jul 1, 2018 Accepting new patients
Dermatology Associates Dermatology PastSince Aug 30, 2020 Accepting new patients

Locations

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

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

300 Richland West Cir
#2C
Waco, TX 76712
Phone (254) 340-6000

300 Richland West Cir
Ste 2C
Waco, TX 76712
Phone (254) 340-6000

Interoperability endpoints

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

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X BP20053749 TX
Dermatology Physician 207N00000X R5338 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

300 Richland West Cir Ste 2C
Waco, TX 76712-7935

Mailing address

5310 Harvest Hill Rd Ste 290
Dallas, TX 75230-5826
Phone (214) 420-0650

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 26, 2020.

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1487074084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650",
            "fax_number": "214-736-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RICHLAND WEST CIR STE 2C",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127935",
            "telephone_number": "254-340-6000",
            "fax_number": "254-340-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "GREGORY",
        "credential": "M.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "BP20053749",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.