Unknown Individual – Family Medicine Physician, NPI 1477556009
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 1239
TROY, MI 480991239
Phone: (248) 824-6600
Fax: (855) 618-6655
Type: Mailing
1301, West 7th Street, Fort Worth, Tarrant County, Texas, 76107, United States
SUITE 121
FORT WORTH, TX 761022651
Phone: (817) 348-0425
Fax: (817) 348-0455
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 476 | 179 | $0 |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 114 | 48 | $0 |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 61 | 49 | $0 |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 52 | 42 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 51 | 51 | $0 |
Insurance plans in this area (ZIP 48099)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | TX | 81002 | Urinalysis, manual test | 156 | 123 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Family Practice | MI | |
| Internal Medicine | TX | |
| Family Practice | MI | |
| - | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | WA | |
| Geriatric Medicine, Internal Medicine | TX |
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