Individual provider Active NPI

Stephanie L Atiyeh, MD

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1659356053
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L9078 Issued in TX
Practice address
7777 Forest LN
Dallas, TX 75230-2505
Phone
(972) 758-3523
NPI assigned
Dec 8, 2005
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L9078 TX Primary

Addresses

Primary practice location

7777 Forest LN
Dallas, TX 75230-2505

Mailing address

PO Box 201606
Dallas, TX 75320-1606
Phone (972) 758-3523

Other identifiers 2

IdentifierTypeStateIssuer
8S2682OtherTXBCBS
0012LYOtherTXBCBS

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912000594 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8325071384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
University of California, San Diego School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Questcare Hospitalists PLLCGroup PAC ID 5799785119, 266 clinicians

Practice addresses (Care Compare)

1950 Record Crossing Rd
Dallas, TX 75235-6223
Phone (954) 939-5000

7777 Forest LN
Dallas, TX 75230-2571
Phone (972) 566-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9078TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Hospitalists PLLC Pediatrics CurrentSince Jan 1, 2018 Accepting new patients
Stephanie L Atiyeh MD PA Pediatrics Past Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

1950 Record Crossing Rd
Dallas, TX 75235
Phone (214) 638-1500

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

2301 Marsh Ln
Plano, TX 75093
Phone (972) 428-1600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1659356053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201606",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753201606",
            "telephone_number": "972-758-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-758-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIYEH",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L9078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S2682",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0012LY",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.