NEURODIAGNOSTIC TEX, LLC – Electrodiagnostic Medicine Physician, NPI 1558314567
Electrodiagnostic Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for NEURODIAGNOSTIC TEX, LLC
Whitehouse Post Office, KY 10;KY 57, Tollesboro, Lewis County, Kentucky, 41189, United States
WHITEHOUSE, TX 757911455
Phone: (903) 534-0809
Fax: (903) 939-9149
Type: Mailing
Old Creek Drive, Tyler, Smith County, Texas, 75703, United States
TYLER, TX 757037642
Phone: (903) 534-0809
Fax: (903) 939-9149
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.
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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: 2004-02-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (805 days ago).
Enrollment records
1
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20040204000739 | O | Independent Diagnostic Testing Facility (Idtf) | TX | 2024-03-31 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | 2,050 | 265 | $0 |
| 95938 | Placement of skin electrodes and measurement of stimulated sites on arms and legs | 340 | 328 | $0 |
| 95927 | Placement of skin electrodes and measurement of stimulated sites in trunk or head | 129 | 127 | $0 |
| 95939 | Placement of skin electrodes and measurement of central motor stimulation in arms and legs | 63 | 60 | $0 |
| 95908 | Nerve conduction, 3-4 studies | 13 | 13 | $0 |
Insurance plans in this area (ZIP 75791)
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