Individual provider Active NPI

Sully Drotar, D.O.

  • Obesity Medicine (Preventive Medicine) Physician
  • Dallas, TX
National Provider Identifier
1861874703
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Preventive Medicine) PhysicianTaxonomy code 2083B0002X
License
R7443 Issued in TX
Practice address
9101 N Central Expy Ste 370
Dallas, TX 75231-5947
Phone
(469) 820-8220
NPI assigned
Jun 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R7443 TX
Obesity Medicine (Preventive Medicine) Physician 2083B0002X R7443 TX Primary

Addresses

Primary practice location

9101 N Central Expy Ste 370
Dallas, TX 75231-5947

Mailing address

2620 Maple Ave Apt 714
Dallas, TX 75201-2696
Phone (918) 691-6187

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
I20180821003276 TX Practitioner - Internal Medicine 2769731942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Suite 1000
Dallas, TX 75246-2037
Phone (469) 800-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7443TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Jul 6, 2020 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 6, 2020 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3417 Gaston Ave
Ste 1000
Dallas, TX 75246
Phone (469) 800-7050

9101 N Central Expy
Ste 370
Dallas, TX 75231
Phone (214) 820-7528

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

Interoperability endpoints

  • Direct secure messaging: sdrotar388506@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1861874703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 MAPLE AVE APT 714",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012696",
            "telephone_number": "918-691-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY STE 370",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315947",
            "telephone_number": "469-820-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROTAR",
        "first_name": "SULLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-28",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R7443",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "TX",
            "license": "R7443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.