DR. SMART O IDEMUDIA (M.D., PHD) – Internal Medicine Physician, NPI 1154364974
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,290 INTERNAL MEDICINE in TX
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Provider Addresses for DR. SMART O IDEMUDIA (M.D., PHD)
PO BOX 292128
LEWISVILLE, TX 750292128
Phone: (972) 420-6777
Fax: (972) 420-0656
Type: Mailing
Grace Medical Association and Wellness Center, 200, West Southwest Parkway, Lewisville, Denton County, Texas, 70567, United States
LEWISVILLE, TX 75067
Phone: (972) 420-6777
Fax: (972) 420-0656
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: 2006-09-18
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 |
|---|---|---|---|---|
| I20060918000456 | I | Internal Medicine | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 173 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 132 | 43 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 13 | 11 | $0 |
Insurance plans in this area (ZIP 75029)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | TX | 82270 | Stool analysis for blood to screen for colon tumors | 37 | 37 |
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