Individual provider Active NPI

Lydia Grace Roward, MD

  • Orthopaedic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1578024170
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
W2120 Issued in TX
Practice address
8811 Village Dr
San Antonio, TX 78217-5415
Phone
(210) 297-2000
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 4271085 ID
Orthopaedic Surgery Physician 207X00000X W2120 TX Primary
Orthopaedic Trauma Physician 207XX0801X 92082 SC
General Practice Physician 208D00000X 0101271452 VA

Addresses

Primary practice location

8811 Village Dr
San Antonio, TX 78217-5415

Mailing address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-7500

Other practice location 1

625 Pole Line Rd W Ste 1B
Twin Falls, ID 83301-4269
Phone (208) 825-2007

Other practice location 2

105 Doctors Dr
Greenville, SC 29605-5608
Phone (864) 797-7060

Other practice location 3

701 Grove Rd
Greenville, SC 29605-4210
Phone (864) 455-7000

Other practice location 4

3551 Roger Brooke Drive
JBSA-Ft Sam Houston, TX 78234-4504
Phone (210) 916-1284

Other practice location 5

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 302-3900

Other names 1

  • Lydia Grace Kore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, ID, SD, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20240827003892 SC Practitioner - Orthopedic Surgery 3779022371 Reassigns benefits to 1 organization
I20251111000564 ID Practitioner - Orthopedic Surgery 3779022371 Reassigns benefits to 2 organizations
I20260112000456 SD Practitioner - Orthopedic Surgery 3779022371 Reassigns benefits to 1 organization
I20260116001425 TX Practitioner - Orthopedic Surgery 3779022371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loma Linda University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery of South Dakota PCGroup PAC ID 5698195030, 67 clinicians

Practice addresses (Care Compare)

2805 5TH St
Rapid City, SD 57701-6003
Phone (605) 646-0953

575 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-9200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101271452VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Surgery Medical Group, Inc. Orthopaedic Surgery CurrentSince Oct 15, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 29, 2024 Accepting new patients
Acute Care Surgery of South Dakota PC Orthopaedic Surgery CurrentSince Dec 1, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 29, 2024 Accepting new patients
Acute Care Surgical Affiliates of Texas PA Orthopaedic Surgery CurrentSince Dec 1, 2025 Accepting new patients
Surgical Affiliates of California CurrentSince Oct 3, 2025 Accepting new patients

Locations

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

625 Pole Line Rd W
Ste 1B
Twin Falls, ID 83301
Phone (208) 814-8100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

105 Doctors Dr
Greenville, SC 29605
Phone (864) 797-7060

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

2805 5th St
Rapid City, SD 57701
Phone (605) 719-5650

2965 Harrison Ave
Ste 217
Beaumont, TX 77702
Phone (409) 203-3055

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

Organizations & group practices 7

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 1

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1578024170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 VILLAGE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175415",
            "telephone_number": "210-297-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Pole Line Rd W Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833014269",
            "country_code": "US",
            "telephone_number": "208-825-2007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055608",
            "country_code": "US",
            "telephone_number": "864-797-7060",
            "fax_number": "864-797-7065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "864-455-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Drive",
            "address_purpose": "LOCATION",
            "city": "JBSA-Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-1284",
            "fax_number": "210-916-7323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-302-3900",
            "fax_number": "208-302-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROWARD",
        "first_name": "LYDIA",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "4271085",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "W2120",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "SC",
            "license": "92082",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101271452",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "KORE",
            "middle_name": "GRACE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.