LIDA LACY EDMUNDSON MD
NPI 1710190889
Psychiatry & Neurology - Psychiatry in Dallas, TX

Active since May 07, 2007Opted out of Medicare · through May 20, 2027
12700 HILLCREST RD, SUITE 260, DALLAS, TX 75230(972) 789-9319(972) 789-9324 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lida Lacy Edmundson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIDA LACY EDMUNDSON MD (NPI 1710190889) is an individual psychiatry provider in Dallas, Texas, licensed in Texas (D3210) and active in the NPI registry since May 2007. She has opted out of Medicare through May 20, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1710190889
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameLIDA LACY EDMUNDSONCredential: MD
Location Address12700 HILLCREST RD, SUITE 260Dallas, TX 75230-2033
Mailing Address12700 Hillcrest Rd, Suite 260Dallas, TX 75230-2033 · (972) 789-9319 · Fax (972) 789-9324
Fax(972) 789-9324
Sole ProprietorYes
Enumeration DateMay 7, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1710190889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License Licensed in TX · D3210
Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

12700 HILLCREST RD, Dallas, TX 75230

Other Identifiers 2

Medicare UPIND49579TX
Medicare ID-Type Unspecified00P843TX

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Lida Lacy Edmundson Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 20, 2019 through May 20, 2027.

Opt-Out Effective DateMay 20, 2019
Opt-Out In Effect ThroughMay 20, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75230 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$172.86 typical visit price
range $57.18 – $172.86
Typical copayment $43.21 (range $14.29 – $43.21)
Most-billed visit code 99205
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Hospice Care, Community Based
12700 HILLCREST RD, SUITE 258
DALLAS, TX 75230
Social Worker (Clinical)
12700 HILLCREST RD, SUITE 258
DALLAS, TX 75230
Counselor (Professional)
12700 HILLCREST RD, SUITE 254
DALLAS, TX 75230
Psychiatry & Neurology (Psychiatry)
12700 HILLCREST RD, SUITE 260
DALLAS, TX 75230
Speech-Language Pathologist
12700 HILLCREST RD, SUITE 258
DALLAS, TX 75230
Speech-Language Pathologist
12700 HILLCREST RD, STE 258
DALLAS, TX 75230
Speech-Language Pathologist
12700 HILLCREST RD, SUITE 258
DALLAS, TX 75230
Speech-Language Pathologist
12700 HILLCREST RD, STE 258
DALLAS, TX 75230

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lida Edmundson's NPI number?

The NPI number for Lida Edmundson is 1710190889. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Where is Lida Edmundson located?

Lida Edmundson practices at 12700 Hillcrest Rd Suite 260, Dallas, TX 75230. The listed phone number is (972) 789-9319.

What is Lida Edmundson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Lida Edmundson enrolled in Medicare?

No. Lida Edmundson has opted out of Medicare through May 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Lida Edmundson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.