Baylor Scott & White Surgicare - Grapevine – Ambulatory Surgical Clinic/Center, NPI 1295702942
Ambulatory Surgical Clinic/Center
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Baylor Scott & White Surgicare - Grapevine
905 E SOUTHLAKE BLVE
STE 200
SOUTHLAKE, TX 760928602
Phone: (817) 410-4300
Fax: (817) 410-4303
Type: Mailing
905 E SOUTHLAKE BLVD
STE 200
SOUTHLAKE, TX 760928602
Phone: (817) 410-4300
Fax: (817) 410-4303
Type: Location
2040, West State Highway 114, Grapevine, Tarrant County, Texas, 76051, United States
GRAPEVINE, TX 760518602
Phone: (817) 410-4300
Fax: (817) 410-4303
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: 2006-04-24
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| O20060424000452 | O | Ambulatory Surgical Center | 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 |
|---|---|---|---|---|
| C9290 | Injection, bupivacaine liposome, 1 mg | 73,815 | 36 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 72 | 72 | $0 |
| 76000 | Imaging guidance for procedure, 60 minutes or less | 40 | 38 | $0 |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 39 | 21 | $0 |
| 64721 | Release and/or relocation of hand nerve | 35 | 30 | $0 |
Insurance plans in this area (ZIP 76092)
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