NPIMap

Individual provider Active NPI

Richard E. Edeen, M.D.

  • Orthopaedic Surgery Physician
  • La Grange, TX
National Provider Identifier
1124382742
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
R7000 Issued in TX
Practice address
2 Saint Marks PL Ste 110
La Grange, TX 78945-1255
Phone
(979) 242-2387
Fax
(979) 242-2206
NPI assigned
Jun 28, 2012
Last updated
Dec 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35130913 OH
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X R7000 TX Primary

Addresses

Primary practice location

2 Saint Marks PL Ste 110
La Grange, TX 78945-1255

Mailing address

2 Saint Marks PL Ste 110
La Grange, TX 78945-1255
Phone (979) 242-2387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808001141 TX Practitioner - Orthopedic Surgery 3375834476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

204 W Windcrest St
Fredericksburg, TX 78624-4408
Phone (830) 997-4043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.68 of 100Reported as group
Quality
84.05
Promoting interoperability
87
Improvement activities
40
Cost
62.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement13
Knee replacement29
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35130913OHMDOrthopaedic Surgery Physician
R7000TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Hill Country Orthopaedics & Sports Medicine P.a. Orthopaedic Surgery CurrentSince Feb 10, 2020 Accepting new patients

Locations

813 S Milam St
Fredericksburg, TX 78624
Phone (830) 997-4043

Organizations & group practices 1

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1124382742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SAINT MARKS PL STE 110",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789451255",
            "telephone_number": "979-242-2387",
            "fax_number": "979-242-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT MARKS PL STE 110",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789451255",
            "telephone_number": "979-242-2387",
            "fax_number": "979-242-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEEN",
        "first_name": "RICHARD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35130913",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "R7000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, TX

Sources for this page

Verify at the official NPI Registry.