Epic Surgery Clinic – Surgery Physician, NPI 1174147086

Epic Surgery Clinic is a healthcare provider. based in Wylie, Texas. specializing in Surgery Physician. The NPI Number for Epic Surgery Clinic is 1174147086

Main info

Organization
Name
Epic Surgery Clinic
NPI
1174147086
Phone
(945) 205-0333
Address
3208 AMBER WAVES LN
Authorized Official
MOHAMED A IBRAHIM MD
Enumeration Date
5 June 2020
Last Update Date
14 October 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness80
Years active:6State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Epic Surgery Clinic

  • 3208 AMBER WAVES LN

    WYLIE, TX 750981216

    Phone: (945) 205-0333

    Fax: (945) 205-0444

    Type: Mailing

  • 1600 COIT RD STE 207

    PLANO, TX 750756172

    Phone: (972) 833-7525

    Type: Location

  • 4108 W 15TH ST STE 200

    PLANO, TX 750935850

    Phone: (972) 833-7525

    Type: Mailing

  • 811 S CENTRAL EXPY STE 103

    RICHARDSON, TX 750807439

    Phone: (945) 205-0333

    Fax: (945) 205-0444

    Type: Location

  • 1402 Medical Dr

    Sulphur Springs, TX 754822199

    Phone: (945) 205-0333

    Fax: (945) 202-0444

    Type: Location

  • 2700 W Pleasant Run Rd

    Suite 370; Physician West Bldg

    Lancaster, TX 751461078

    Phone: (945) 205-0333

    Fax: (945) 205-0444

    Type: Location

  • 9 MEDICAL PARKWAY, PLAZA 4

    SUITE 102

    FARMERS BRANCH, TX 752347852

    Phone: (945) 205-0333

    Fax: (945) 205-0444

    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: 2020-06-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-12-31 (159 days ago).

Enrollment records

1

Earliest due date

2025-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20200611001968OClinic/Group PracticeTX2025-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75098)

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Reviews

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Frequently asked questions

What number should I use to identify Epic Surgery Clinic for billing?
Administrative and clinical systems typically use NPI 1174147086 for Epic Surgery Clinic.
Is Epic Surgery Clinic currently accepting referrals based on NPI status?
Registry metadata lists Epic Surgery Clinic as active.
What does the directory say Epic Surgery Clinic does?
Insurance directories may phrase it differently, but here Epic Surgery Clinic maps to Surgery Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Epic Surgery Clinic?
Epic Surgery Clinic shows a connection to Wylie, Texas in registry-derived data.
Who maintains Epic Surgery Clinic's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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