NPIMap

Individual provider Active NPI

Lydia F. Owen-Wyatt, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1689657132
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00528 Issued in TX
Practice address
3310 Live Oak St FL 3
Youth & Family Center
Dallas, TX 75204-6153
Phone
(214) 266-1257
Fax
(214) 266-1258
NPI assigned
Nov 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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 PA00528 TX Primary

Addresses

Primary practice location

3310 Live Oak St FL 3
Youth & Family Center
Dallas, TX 75204-6153

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 8

IdentifierTypeStateIssuer
060359902MedicaidTX
060359904MedicaidTX
060359907MedicaidTX
P00049546OtherRAILROAD MEDICARE
060359905MedicaidTX
060359906MedicaidTX
8N4424OtherTXBLUE CROSS BLUE SHIELD
060359903MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000231 TX Practitioner - Physician Assistant 7618026048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1800 N Britain Rd
Parkland Health
Irving, TX 75061-2630
Phone (214) 266-3000

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00528TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Apr 5, 2009 Accepting new patients
Dallas County Hospital District CurrentSince Apr 5, 2009 Accepting new patients
Vickery Health Center Past Accepting new patients

Locations

8224 Park Ln
Dallas, TX 75231
Phone (214) 266-0350

3310 Live Oak St
Fl 3
Dallas, TX 75204
Phone (214) 266-1251

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: lwyatt426@direct.phhs.org

Organizations & group practices 4

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1689657132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST FL 3",
            "address_2": "YOUTH & FAMILY CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046153",
            "telephone_number": "214-266-1257",
            "fax_number": "214-266-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN-WYATT",
        "first_name": "LYDIA",
        "middle_name": "F.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359907",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00049546",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359905",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359906",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N4424",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060359903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.