--SELECT-- – Internal Medicine Physician, NPI 1225514680
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for --SELECT--
Old Newman Road, Windsor Place, Frisco, Denton County, Texas, 75034, United States
FRISCO, TX 750348184
Phone: (718) 879-0325
Type: Location
200 E Evergreen St Ste 200A
Sherman, TX 750905056
Phone: (469) 888-4890
Type: Location
2008 E Hebron Pkwy Ste 120
Carrollton, TX 750071601
Phone: (469) 888-4890
Type: Location
2545 FOREST BREEZE DR
FRISCO, TX 750340070
Phone: (718) 879-0325
Type: Mailing
14111 KING RD STE 320
FRISCO, TX 750368981
Phone: (718) 879-0325
Type: Mailing
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: 2018-10-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (949 days ago).
Enrollment records
1
Earliest due date
2023-10-31
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 |
|---|---|---|---|---|
| O20181020000029 | O | Clinic/Group Practice | TX | 2023-10-31 |
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.
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 75034)
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Reviews
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