CLYDE FAGG III SANFORD (MD) – Cardiovascular Disease Physician, NPI 1528053857
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,430 CARDIOVASCULAR DISEASE (CARDIOLOGY) in TX
Provider Addresses for CLYDE FAGG III SANFORD (MD)
2026 S Jackson St
Jacksonville, TX 757665822
Phone: (903) 586-5678
Type: Location
1783 Troup Hwy
Tyler, TX 757015869
Phone: (903) 595-2283
Type: Location
CHRISTUS Louis & Peaches Owen Heart Hospital, 703, South Fleishel Avenue, Tyler, Smith County, Texas, 75702, United States
STE 4000
TYLER, TX 757012015
Phone: (903) 606-7000
Type: Location
3201 S Loop 256
Palestine, TX 758016901
Phone: (903) 723-8800
Type: Location
619 S Fleishel Ave Ste 100
Tyler, TX 757012004
Phone: (903) 606-2299
Type: Location
700 E Marshall Ave
Longview, TX 756015580
Phone: (903) 315-2777
Type: Location
703 E Marshall Ave Ste 5008
Longview, TX 756015557
Phone: (903) 315-4880
Type: Location
619 S Fleishel Ave Ste 201
Tyler, TX 757012004
Phone: (903) 606-5777
Type: Location
100 Medical Cir
Sulphur Springs, TX 754822138
Phone: (903) 885-3181
Type: Location
PO BOX 846098
DALLAS, TX 752846098
Phone: (903) 324-6450
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $612.
Total Amount is formed as General ($612) + Research ($0) + Ownership ($0) = $612.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: HeartFlow, Inc. ($137).
Total Amount
$612
General + Research + Ownership
Payments
18
Total payment records
General Amount
$612
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
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: 2010-03-16
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 |
|---|---|---|---|---|
| I20100316000739 | I | Cardiovascular Disease (Cardiology) | 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 |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 845 | 708 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 661 | 577 | $0 |
| 85610 | Blood test, clotting time | 285 | 40 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 254 | 251 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 213 | 47 | $0 |
Insurance plans in this area (ZIP 75766)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | TX | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 213 | 209 |
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | TX | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 1600 | 1335 |
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | TX | 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 100 | 56 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | AZ | |
| Internal Medicine | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| - | TX | |
| E N D O C R I N O L O G Y | TX | |
| Nurse Practitioner | IL | |
| - | NC | |
| Physician Assistant | LA | |
| Hospitalist, Gastroenterology | TX |
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