Lumina Psychiatry & Wellness – Psychiatry Physician, NPI 1619408911
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Lumina Psychiatry & Wellness
2160 N Lake Forest Dr Ste 600
McKinney, TX 750715156
Phone: (972) 707-2100
Fax: (972) 707-3100
Type: Location
322 BASTROP BLVD
FAIRVIEW, TX 750691283
Phone: (972) 707-2100
Fax: (972) 707-3100
Type: Mailing
PO BOX 3208
MCKINNEY, TX 750708185
Phone: (469) 631-0935
Fax: (940) 435-7059
Type: Mailing
Medical Center Drive, McKinney, Collin County, Texas, 75609, United States
200
MCKINNEY, TX 750691766
Phone: (469) 631-0935
Fax: (940) 435-7059
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2017-04-26
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 |
|---|---|---|---|---|
| O20170426002299 | O | Clinic/Group Practice | 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 75071)
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