Southwest Orthopaedic Group – Orthopaedic Surgery Physician, NPI 1699761494
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Southwest Orthopaedic Group
815 Highway 71
Bldg 1, Suite 1150
Bastrop, TX 78602
Phone: (512) 451-1969
Fax: (512) 458-2327
Type: Location
Moody Orthodontics, 2500, West William Cannon Drive, Cherry Meadows, Austin, Travis County, Texas, 78745, United States
STE 401
AUSTIN, TX 787455257
Phone: (512) 451-1969
Fax: (512) 458-2327
Type: Mailing
5200 DAVIS LANE SUITE B200
AUSTIN, TX 78749
Phone: (512) 451-1969
Fax: (512) 458-2327
Type: Location
3101 Highway 71 E Ste 207
Bastrop, TX 786025157
Phone: (512) 451-1969
Fax: (512) 458-2327
Type: Location
2 Saint Marks Pl Ste 130
LA Grange, TX 789451259
Phone: (512) 451-1969
Fax: (512) 458-2327
Type: Location
7951 SHOAL CREEK BLVD STE 300
AUSTIN, TX 787577582
Phone: (512) 584-8404
Fax: (512) 458-2327
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (891 days ago).
Enrollment records
2
Earliest due date
2023-12-31
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 |
|---|---|---|---|---|
| O20040219000410 | O | Clinic/Group Practice | TX | 2023-12-31 |
| O20100930021373 | O | Physician - General Surgery | TX | 2026-09-30 |
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 78602)
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