MRS. AUTUMN N. LYDICK (AGACNP-BC) – Acute Care Nurse Practitioner, NPI 1932680105
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. AUTUMN N. LYDICK (AGACNP-BC)
3619, Clear Falls Drive, Hunters Ridge, Houston, Harris County, Texas, 77339, United States
KINGWOOD, TX 773391962
Phone: (409) 749-4193
Type: Mailing
300, Medical Center Boulevard, Conroe, Montgomery County, Texas, 77304, United States
CONROE, TX 773042808
Phone: (409) 749-4193
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $32.
Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.
Last reported payment date: 2023-06-13 • Largest payer in this snapshot: Medtronic, Inc. ($32).
Total Amount
$32
General + Research + Ownership
Payments
1
Total payment records
General Amount
$32
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $32 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-05-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190515000305 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77339)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Thoracic Surgery, Vascular Surgery | TX | |
| Medical Oncology, Hematology | TX | |
| Internal Medicine | TX | |
| General Surgery | NY | |
| G A S T R O E N T E R O L O G Y | LA | |
| Internal Medicine | TX |
Reviews
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