Individual provider Active NPI

Izabella Dutra de Abreu, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1811256688
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R2087 Issued in TX
Practice address
6363 Forest Parke Road
Suite 749
Dallas, TX 75390-9121
Phone
(214) 645-8500
Fax
(214) 645-3775
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X BP10043212 TX
Psychiatry Physician 2084P0800X R2087 TX Primary

Addresses

Primary practice location

6363 Forest Parke Road
Suite 749
Dallas, TX 75390-9121

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other identifiers 1

IdentifierTypeStateIssuer
UZFAN3980781OtherAZBLUE CROSS BLUE SHIELD

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
I20170728002559 TX Practitioner - Psychiatry 1456622166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1430 Empire Central Dr
Dallas, TX 75247-4032
Phone (214) 645-8500

3000N Interstate 35
Denton, TX 76201-5119
Phone (469) 303-3591

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-5582

5201 Harry Hines VLVD
Dallas, TX 75235-7708
Phone (214) 590-5582

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10043212TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Psychiatry CurrentSince Sep 1, 2017 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2017 Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: izabella.dutradeabreu@direct.swmed.us

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811256688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FOREST PARKE ROAD",
            "address_2": "SUITE 749",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909121",
            "telephone_number": "214-645-8500",
            "fax_number": "214-645-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTRA DE ABREU",
        "first_name": "IZABELLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "BP10043212",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "UZFAN3980781",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.