Individual provider Active NPI

Michael L Lydic, M.D.

  • Reproductive Endocrinology Physician
  • Overland Park, KS
National Provider Identifier
1922035690
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
04-38611 Issued in KS
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

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01816444MedicaidNY
4640733OtherNYAETNA
48G612OtherNYEMPIRE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122000320 KS Practitioner - Obstetrics/GynecologyPractitioner - Endocrinology 5698899383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Endocrinology
Education
Hahnemann University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

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 100Reported as apm
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

LicenseStateTypeSpecialty
2015041854MOMDReproductive Endocrinology Physician
209845NYMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Reproductive Endocrinology CurrentSince Sep 28, 2016 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Sep 28, 2016 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.