OrganizationActive
Illuminate Medical Group PLLC
NPI 1679036891 · Adult Medicine Physician · Lantana, TX
Provider details
- NPI number
- 1679036891
- Entity type
- Organization
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Matthew Roberson, Owner / Ceo(940) 220-9996
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1028 Truman Rd
Lantana, TX 76226-4395
Phone: (940) 220-9996
Street-level locationGet directions
Mailing address
1028 Truman Rd
Lantana, TX 76226-4395
Registry dates
- Enumerated
- 2019-04-14
- Last updated
- 2026-02-20
- Certified
- 2026-02-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.