Individual provider Active NPI

Glynn John Pickens, MD

  • Urology Physician
  • Rockwall, TX
National Provider Identifier
1720023070
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
J0199 Issued in TX
Practice address
890 Rockwall Pkwy
Suite 110
Rockwall, TX 75032-6872
Phone
(972) 276-6191
Fax
(972) 454-6893
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X J0199 TX Primary

Addresses

Primary practice location

890 Rockwall Pkwy
Suite 110
Rockwall, TX 75032-6872

Mailing address

3600 Gaston Ave
Suite 1205
Dallas, TX 75246-1800
Phone (214) 692-8262

Other identifiers 1

IdentifierTypeStateIssuer
045376302MedicaidTX

Other names 1

  • Dr. John Pickens Other name

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
I20060118000532 TX Practitioner - Urology 1557306487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Clinics of North Texas, PLLCGroup PAC ID 5496736415, 72 clinicians

Practice addresses (Care Compare)

6460 Naaman Forest Blvd
Garland, TX 75044-5601
Phone (972) 494-6764

Hospital & facility affiliations

  • Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537
  • Texas Health Presbyterian Hospital Rockwall Hospital, Rockwall, TX, CCN 670044
  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
  • Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352

Merit-based Incentive Payment System (MIPS)

Final score
90.14 of 100Reported as group
Quality
97.48
Promoting interoperability
100
Improvement activities
40
Cost
69.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Clinics of North Texas, PLLC Urology CurrentSince Jan 1, 2006 Accepting new patients
Urology Clinics of North Texas, PLLC Urology Current Accepting new patients
Urology Clinics of North Texas, PLLC CurrentSince Jan 1, 2006 Accepting new patients
Urology Clinics of North Texas PLLC Past Accepting new patients

Locations

3600 Gaston Ave
Ste 1205
Dallas, TX 75246

12606 Greenville Ave
Ste 160
Dallas, TX 75243
Phone (469) 364-7880

7777 Forest Ln
Ste A230
Dallas, TX 75230
Phone (972) 566-7765

9900 N Central Expy
Ste 120
Dallas, TX 75231
Phone (214) 580-2265

12606 Greenville Ave
Ste 185
Dallas, TX 75243
Phone (214) 739-1706

9900 N Central Expy
Ste 130
Dallas, TX 75231

2241 Peggy Ln
Ste E
Garland, TX 75042
Phone (972) 276-6191

6460 Naaman Forest Blvd
Garland, TX 75044
Phone (817) 481-0111

1650 Republic Pkwy
Ste 150
Mesquite, TX 75150
Phone (214) 692-8262

1650 Republic Pkwy
Ste 130
Mesquite, TX 75150

6957 W Plano Pkwy
Ste 1300
Plano, TX 75093
Phone (972) 820-1400

6124 W Parker Rd
Ste 434
Plano, TX 75093
Phone (214) 750-0808

890 Rockwall Pkwy
Ste 110
Rockwall, TX 75032
Phone (972) 494-6764

Interoperability endpoints

  • Direct secure messaging: glynn.pickens.p1@direct.urologyclinics.nextgenshare.com

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1720023070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "SUITE 1205",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-692-8262",
            "fax_number": "214-696-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 ROCKWALL PKWY",
            "address_2": "SUITE 110",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326872",
            "telephone_number": "972-276-6191",
            "fax_number": "972-454-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "GLYNN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "J0199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045376302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "PICKENS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.