Individual provider Active NPI

Kyle Lyndon Boatman, NP

  • Family Nurse Practitioner
  • Flower Mound, TX
National Provider Identifier
1912483660
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP137823 Issued in TX
Practice address
4001 Long Prairie Rd Ste 160
Flower Mound, TX 75028-1528
Phone
(972) 355-1505
NPI assigned
Jul 16, 2018
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP137823 TX Primary

Addresses

Primary practice location

4001 Long Prairie Rd Ste 160
Flower Mound, TX 75028-1528

Mailing address

4001 Long Prairie Rd Ste 160
Flower Mound, TX 75028-1528

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926000704 TX Practitioner - Nurse Practitioner 7719238005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

4001 Long Prairie Rd
Suite 160
Flower Mound, TX 75028-1528
Phone (972) 355-1505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Family Medicine CurrentSince Oct 26, 2020 Accepting new patients
Texas Health Physicians Group CurrentSince Oct 26, 2020 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

12606 Greenville Ave
Ste 200
Dallas, TX 75243
Phone (214) 660-2020

9330 Amberton Pkwy
Ste 1244
Dallas, TX 75243
Phone (214) 200-2551

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: kboatman1663104@direct.texashealth.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.

Hospital & facility affiliations 3

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1912483660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD STE 160",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD STE 160",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281528",
            "telephone_number": "972-355-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATMAN",
        "first_name": "KYLE",
        "middle_name": "LYNDON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.