Individual provider Active NPI

Melinda Dawn Conroy, D.O.

  • Dermatology Physician
  • Lakeway, TX
National Provider Identifier
1760650428
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N6231 Issued in TX
Practice address
401 Ranch Road 620 S Ste 200
Lakeway, TX 78734-5304
Phone
(512) 610-0549
Fax
(512) 540-8853
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X N6231 TX Primary

Addresses

Primary practice location

401 Ranch Road 620 S Ste 200
Lakeway, TX 78734-5304

Mailing address

401 Ranch Road 620 S Ste 200
Lakeway, TX 78734-5304
Phone (512) 610-0549

Other identifiers 2

IdentifierTypeStateIssuer
8CK978OtherTXBCBS IND. NUMBER
215686101MedicaidTX

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
I20101004000854 TX Practitioner - Dermatology 4284826678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

401 RR
620 Suite 200
Lakeway, TX 78734-3910
Phone (512) 610-0549

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24
Removal of skin lesions976
Removal or shaving of skin growth1-10
Skin biopsy317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology PA Dermatology Current Accepting new patients
Westlake Dermatology PA Dermatology CurrentSince Aug 2, 2010 Accepting new patients
Westlake Dermatology, PA Dermatology CurrentSince Aug 2, 2010 Accepting new patients

Locations

8825 FM 2244 Rd
Ste 100
Austin, TX 78746

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

401 S FM 620 Rd
Ste 200
Lakeway, TX 78734
Phone (512) 610-0549

1760 Round Rock Ave
Round Rock, TX 78681
Phone (512) 583-3376

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1760650428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RANCH ROAD 620 S STE 200",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345304",
            "telephone_number": "512-610-0549",
            "fax_number": "512-666-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RANCH ROAD 620 S STE 200",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345304",
            "telephone_number": "512-610-0549",
            "fax_number": "512-540-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "MELINDA",
        "middle_name": "DAWN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N6231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND. NUMBER",
            "identifier": "8CK978",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215686101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.