Individual provider Active NPI

Tristan T Boyd, P.T.

  • Physical Therapist
  • Frisco, TX
National Provider Identifier
1780727560
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1173420 Issued in TX
Practice address
5997 Dustin TRL
Frisco, TX 75034-4048
Phone
(706) 631-9994
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1173420 TX Primary

Addresses

Primary practice location

5997 Dustin TRL
Frisco, TX 75034-4048

Mailing address

5997 Dustin TRL
Frisco, TX 75034-4048
Phone (706) 631-9994

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stt@116.direct.myezyaccess.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608001757 TX Practitioner - Physical Therapist in Private Practice 9931477312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Back CareGroup PAC ID 1951604313, 50 clinicians

Practice addresses (Care Compare)

1545 E Southlake Blvd
Southlake, TX 76092-6422
Phone (817) 748-8701

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6465
Phone (682) 651-1908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1173420TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Back Care Physical Therapist CurrentSince Oct 22, 2018 Accepting new patients
Texas Health Back Care Physical Therapist Current Accepting new patients

Locations

1340 S Main St
Ste 100
Grapevine, TX 76051
Phone (682) 651-1908

1545 E Southlake Blvd
Southlake, TX 76092
Phone (817) 557-8205

1545 E Southlake Blvd
Ste 100
Southlake, TX 76092

Organizations & group practices 2

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1780727560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5997 DUSTIN TRL",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344048",
            "telephone_number": "706-631-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5997 DUSTIN TRL",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344048",
            "telephone_number": "706-631-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TRISTAN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1173420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stt@116.direct.myezyaccess.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1545 E Southlake Blvd Ste 100",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760926465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.