THR/STT SOUTHLAKE ASC, LLC – Ambulatory Surgical Clinic/Center, NPI 1982716106
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for THR/STT SOUTHLAKE ASC, LLC
Texas Health Harris Methodist Hospital Southlake, 1545, East Southlake Boulevard, Park Village, Southlake, Tarrant County, Texas, 76092, United States
SUITE 100
SOUTHLAKE, TX 76092
Phone: (817) 442-9300
Fax: (817) 416-0108
Type: Mailing
290, Miron Drive, Southlake, Tarrant County, Texas, 76092, United States
SOUTHLAKE, TX 760927858
Phone: (817) 442-9300
Fax: (817) 416-0108
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: 2005-05-02
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 |
|---|---|---|---|---|
| O20050502000489 | 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 |
|---|---|---|---|---|
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 847 | 421 | $0 |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 301 | 103 | $0 |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 160 | 100 | $0 |
| 64490 | Injection of upper or middle spine facet joint using imaging guidance, single level | 127 | 52 | $0 |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 101 | 64 | $0 |
Insurance plans in this area (ZIP 76092)
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