STANDARD MEDICAL CLINIC, PA – Internal Medicine Physician, NPI 1316096647
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for STANDARD MEDICAL CLINIC, PA
3712 Gulfway Dr
Port Arthur, TX 776422828
Phone: (409) 332-4300
Fax: (409) 727-5933
Type: Location
190 Strickland Dr
Orange, TX 776304748
Phone: (409) 920-4037
Fax: (409) 727-5933
Type: Location
810 Hospital Dr Ste 320
Beaumont, TX 777014655
Phone: (409) 833-2266
Fax: (409) 727-5933
Type: Location
Houston Post Office, 2087, AR 60, Houston, Perry County, Arkansas, 72070, United States
MSC 200
HOUSTON, TX 772104580
Phone: (409) 727-2808
Type: Mailing
8333 9TH AVE STE A
PORT ARTHUR, TX 776428151
Phone: (409) 727-2808
Fax: (409) 727-5933
Type: Mailing
8333, 9th Avenue, Port Arthur, Jefferson County, Texas, 77642, United States
SUITE A
PORT ARTHUR, TX 776428151
Phone: (409) 727-2808
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: 2005-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-06-30 (343 days ago).
Enrollment records
1
Earliest due date
2025-06-30
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 |
|---|---|---|---|---|
| O20050301000613 | O | Clinic/Group Practice | TX | 2025-06-30 |
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 77642)
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