MAXINE A THERIOT (MD) – Undersea and Hyperbaric Medicine (Preventive Medicine) Physician, NPI 1194874628
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,705 FAMILY PRACTICE in TX
Provider Addresses for MAXINE A THERIOT (MD)
PO BOX 224702
DALLAS, TX 752224702
Phone: (972) 579-5222
Fax: (972) 579-3900
Type: Mailing
1650 W College St
Grapevine, TX 760513565
Phone: (972) 816-0459
Type: Location
400 W INTERSTATE HWY 635 STE 130
IRVING, TX 750633700
Phone: (972) 579-5222
Fax: (972) 597-3900
Type: Location
709 W RUSK ST STE B
ROCKWALL, TX 750873600
Phone: (972) 786-0140
Fax: (972) 786-0142
Type: Mailing
3098 OAK GROVE RD
POPLAR BLUFF, MO 639018938
Phone: (573) 686-8199
Fax: (573) 686-8398
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $286.
Total Amount is formed as General ($286) + Research ($0) + Ownership ($0) = $286.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Smith+Nephew, Inc. ($130).
Total Amount
$286
General + Research + Ownership
Payments
13
Total payment records
General Amount
$286
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $130 |
| Kerecis Limited | $46 |
| Organogenesis Inc. | $44 |
| KCI USA, Inc. | $22 |
| ConvaTec Inc. | $15 |
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: 2023-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20070517000348 | I | Family Practice | TX | TBD |
| I20230322000964 | I | Family Practice | MO | 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 | 350 | 87 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 337 | 92 | $0 |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 235 | 20 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 90 | 62 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 76 | 38 | $0 |
Insurance plans in this area (ZIP 75222)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | TX | 11042 | Removal of skin and tissue first 20 sq cm or less | 395 | 108 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | FL | |
| Cardiovascular Disease (Cardiology) | MO | |
| O T O L A R Y N G O L O G Y | MO | |
| - | MO | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO | |
| Physician Assistant | MO |
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