Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

NPI 1629200308

Individual provider · NPI 1629200308 Deactivated

This NPI was deactivated on October 29, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1629200308 practises Orthopedic Surgery. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2009, 17 years ago. Practices with Texas Specialty Physicians, a 58-clinician group, works from 4 locations and accepts Medicare assignment.

Years since qualifying
17
Trained at
Lake Erie College of Osteopathic Medicine, Erie

Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

Additional practice locations (3)

  • 744 W 9th St # H410, Tulsa, OK 74127-9020 — (918) 599-5949
  • 744 W 9th St # H410, Tulsa, OK 74127-9020 — (918) 599-5949
  • 1123 S Palestine St, Athens, TX 75751-3646 — (190) 367-5952

Specialties & licences

Record details

NPI number1629200308
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2009 (17 years in practice)
Group practice Texas Specialty Physicians — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Procedures

From CMS Care Compare, which counts the procedures a clinician billed to Original Medicare and Medicare Advantage over a recent 12-month period. CMS reports a fixed list of common procedures, so this is not everything the clinician does. Counts of 10 or fewer are given as a range, because CMS withholds small numbers.

Knee replacement 1–10 times
Upper limb (arm) arthroscopy (minimally invasive joint repair) 1–10 times

The percentile compares how often this clinician performed the procedure with other clinicians who performed it, as CMS calculates it. It measures volume, not outcomes or skill.

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients178
Services billed 2,810 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $447 7 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Texas Specialty Physicians

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 58 clinicians in the practice; 12 are shown here.