Active NPI
Michael L Lydic, M.D.
- Reproductive Endocrinology Physician
- Overland Park, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- 04-38611
- Practice address
- 10777 Nall Ave
Suite 200
Overland Park, KS 66211-1362 - Phone
- (913) 588-2229
- Fax
- (913) 588-6258
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | 209845 | NY | |
| Reproductive Endocrinology Physician | 207VE0102X | 04-38611 | KS | Primary |
| Reproductive Endocrinology Physician | 207VE0102X | 2015041854 | MO |
Addresses
Primary practice location
10777 Nall Ave
Suite 200
Overland Park, KS 66211-1362
Mailing address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01816444 | Medicaid | NY | |
| 4640733 | Other | NY | AETNA |
| 48G612 | Other | NY | EMPIRE BC.BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Hahnemann University College of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3901 Rainbow Blvd
Kansas City, KS 66160-7415
Phone (913) 588-3315
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.91 of 100
- Quality
- 77.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015041854 | MO | MD | Reproductive Endocrinology Physician |
| 209845 | NY | MD | Reproductive Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas University Physicians Inc | Reproductive Endocrinology | Current | Accepting new patients |
| Kansas University Physicians Inc | Current | Accepting new patients | |
| Kansas University Physicians Inc | Current | Accepting new patients | |
| Kansas University Physicians Inc | Past | Accepting new patients |
Locations
3901 Rainbow Blvd
#5300
Kansas City, KS 66160
Phone (913) 588-6210
3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005
10777 Nall Ave
Ste 200
Overland Park, KS 66211
Phone (913) 588-2229
Interoperability endpoints
- mlydic539772@direct.kuha.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Kansas City, KS
- NPI 1003858333
-
- Obstetrics & Gynecology Physician
- Kansas City, KS
- NPI 1053457978
Reproductive Endocrinology
-
- Cardiovascular Disease Physician
- Kansas City, KS
- NPI 1407637291
-
- Internal Medicine Physician
- Kansas City, KS
- NPI 1699811521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1922035690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661608500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10777 NALL AVE",
"address_2": "SUITE 200",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111362",
"telephone_number": "913-588-2229",
"fax_number": "913-588-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDIC",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "NY",
"license": "209845",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "KS",
"license": "04-38611",
"primary": true
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MO",
"license": "2015041854",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01816444",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4640733",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC.BS",
"identifier": "48G612",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.