Crystalia S. Weidner, PHD, HSPP

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

1430 Empire Central Dr
Dallas, TX 75247-4032

Phone

(214) 645-8500

NPI assigned

Aug 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment Care Compare group NPD
• Bowen Health Inc

  dba Otis R Bowen Center

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1871072348",
    "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": "1430 EMPIRE CENTRAL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474032",
            "telephone_number": "214-645-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "CRYSTALIA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rick Allen Weideman, PHARMD
• Aaron Thomas Weidenaar, PT, DPT
• Sidney Weidenbach, PT, DPT
• Laurence A Weider, M.D.
• Maria Elizabeth Weidmer Mikhail, MD
• Alan Victor Weier, MD
• Sofia Weigel, MD
• Weight Loss Management LLP
• Patricia Ann Weigle, CRNP
• Roger Allen Weikum, OD

• Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.