Individual provider Active NPI

Tyler Nathaniel Lemm, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1497239263
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12545 Issued in TX
Practice address
3600 Gaston Ave Ste 550
Dallas, TX 75246-1905
Phone
(214) 821-1177
Fax
(214) 821-1193
NPI assigned
Sep 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12545 TX Primary

Addresses

Primary practice location

3600 Gaston Ave Ste 550
Dallas, TX 75246-1905

Mailing address

2023 Crest Ridge Dr
Dallas, TX 75228-3232
Phone (512) 924-2831

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlemm440852@direct.sw.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213001454 TX Practitioner - Physician Assistant 4486992641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

12230 Coit Rd
Suite 100
Dallas, TX 75251-2323
Phone (214) 252-7020

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA12545TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 14, 2019 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

12230 Coit Rd
Ste 100
Dallas, TX 75251
Phone (214) 252-7020

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1497239263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 CREST RIDGE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283232",
            "telephone_number": "512-924-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461905",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMM",
        "first_name": "TYLER",
        "middle_name": "NATHANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlemm440852@direct.sw.org",
            "affiliation": "N",
            "address_1": "12230 Coit Rd Ste 100",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752512323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.