Individual provider Active NPI

Michael Saul Khazzam, MD

  • Orthopaedic Surgery Physician
  • Grapevine, TX
National Provider Identifier
1093821902
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
N9576 Issued in TX
Practice address
1631 Lancaster Dr Ste 230
Grapevine, TX 76051-3586
Phone
(469) 800-7200
Fax
(469) 800-7210
NPI assigned
Aug 22, 2006
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X T2005031078 MO
Orthopaedic Surgery Physician 207X00000X N9576 TX Primary

Addresses

Primary practice location

1631 Lancaster Dr Ste 230
Grapevine, TX 76051-3586

Mailing address

1631 Lancaster Dr Ste 230
Grapevine, TX 76051-3586
Phone (469) 800-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111007000379 TX Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8325190333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1600 W College St
Suite 490
Grapevine, TX 76051-2106
Phone (817) 310-0869

1650 W College St
Grapevine, TX 76051-3565
Phone (817) 388-3440

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T2005031078MOMDOrthopaedic Surgery Physician
N9576TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Orthopaedic Surgery CurrentSince Aug 1, 2011 Accepting new patients
Healthtexas Provider Network CurrentSince Feb 24, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2011 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Healthtexas Provider Network CurrentSince Feb 24, 2025 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Sports Medicine & Orthopedic Center, S.C. Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

12400 Dallas Pkwy
Frisco, TX 75033
Phone (469) 495-2000

1631 Lancaster Dr
Ste 230
Grapevine, TX 76051
Phone (817) 329-2555

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: mkhazzam1360676@direct.sw.org
  • Direct secure messaging: mkhazzam1663970@direct.texashealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1093821902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 LANCASTER DR STE 230",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513586",
            "telephone_number": "469-800-7200",
            "fax_number": "469-800-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 LANCASTER DR STE 230",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513586",
            "telephone_number": "469-800-7200",
            "fax_number": "469-800-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZZAM",
        "first_name": "MICHAEL",
        "middle_name": "SAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "T2005031078",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "N9576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.