Individual provider Active NPI

Andrea Lynn Lundell, M.D,

  • Diagnostic Radiology Physician
  • Rockwall, TX
National Provider Identifier
1619938354
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L1118 Issued in TX
Practice address
105 Liberty LN
Rockwall, TX 75032-8462
Phone
(972) 722-3766
NPI assigned
Mar 31, 2006
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X L1118 TX
Neuroradiology Physician 2085N0700X L1118 TX
Nuclear Radiology Physician 2085N0904X L1118 TX
Pediatric Radiology Physician 2085P0229X L1118 TX
Therapeutic Radiology Physician 2085R0203X L1118 TX
Vascular & Interventional Radiology Physician 2085R0204X L1118 TX
Radiological Physics Physician 2085R0205X L1118 TX
Diagnostic Ultrasound Physician 2085U0001X L1118 TX
Diagnostic Radiology Physician 2085R0202X L1118 TX Primary

Addresses

Primary practice location

105 Liberty LN
Rockwall, TX 75032-8462

Mailing address

105 Liberty LN
Rockwall, TX 75032-8462
Phone (972) 722-3766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040826001374 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9436124153 Reassigns benefits to 1 organization
I20060911000433 TX Practitioner - Diagnostic Radiology 9436124153 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1118TXMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Btdi JV LLP CurrentSince Apr 23, 2019 Accepting new patients
Btdi JV LLP CurrentSince Jan 1, 2023 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Aug 1, 2020 Accepting new patients
Btdi JV LLP CurrentSince Mar 1, 2024 Accepting new patients
Btdi JV LLP CurrentSince Nov 25, 2021 Accepting new patients
Open Air Imaging Center, LLP CurrentSince Apr 26, 2017 Accepting new patients
Btdi JV LLP CurrentSince Apr 23, 2019 Accepting new patients
Btdi JV LLP CurrentSince May 5, 2022 Accepting new patients
Btdi JV, LLP CurrentSince Aug 1, 2023 Accepting new patients
Btdi JV LLP CurrentSince Jan 1, 2023 Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Aug 1, 2020 Accepting new patients
Btdi JV LLP CurrentSince Oct 1, 2023 Accepting new patients
Btdi JV, LLP CurrentSince Nov 1, 2023 Accepting new patients
Btdi JV LLP CurrentSince Apr 23, 2019 Accepting new patients
Btdi JV LLP CurrentSince Nov 25, 2021 Accepting new patients
Btdi JV, LLP CurrentSince Sep 1, 2024 Accepting new patients
Btdi JV LLP CurrentSince Sep 30, 2023 Accepting new patients
Blue Stone JV LLP CurrentSince Oct 1, 2024 Accepting new patients
Btdi JV, LLP CurrentSince Apr 23, 2019 Accepting new patients
Btdi JV LLP CurrentSince Apr 23, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University Radiology Network Inc Diagnostic Radiology Past Accepting new patients
Elizabeth a Jekot MD PA Body Imaging Past Accepting new patients
Medical Center Radiologists Inc Diagnostic Radiology Past Accepting new patients

Locations

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

1901 Medi Park Dr
Ste 2050
Amarillo, TX 79106
Phone (806) 355-3352

7400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-8480

Organizations & group practices 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1619938354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LIBERTY LN",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750328462",
            "telephone_number": "972-722-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LIBERTY LN",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750328462",
            "telephone_number": "972-722-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": "L1118",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L1118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.