Unknown Individual – Surgery Physician, NPI 1558505511
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2078, Hairston Creek Parkway, Kings Ridge, Decatur, DeKalb County, Georgia, 30035, United States
DECATUR, TX 762346156
Phone: (940) 626-8820
Fax: (940) 626-8821
Type: Mailing
Ben Merritt Drive, Decatur, Wise County, Texas, 76234, United States
DECATUR, TX 762343851
Phone: (940) 249-9009
Fax: (940) 626-8684
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $198.
Total Amount is formed as General ($198) + Research ($0) + Ownership ($0) = $198.
Last reported payment date: 2023-12-19 • Largest payer in this snapshot: Medtronic, Inc. ($132).
Total Amount
$198
General + Research + Ownership
Payments
4
Total payment records
General Amount
$198
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $132 |
| Baxter Healthcare | $23 |
| Novo Nordisk Inc | $22 |
| Ethicon US, LLC | $21 |
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.
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 |
|---|---|---|---|---|
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 76234)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| - | TX | |
| - | TX | |
| - | TX | |
| General Surgery, Vascular Surgery | TX | |
| - | TX | |
| - | TX | |
| - | TX | |
| - | TX | |
| - | TX |
Reviews
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