Individual provider Active NPI

Michael David Duchamp, DO

  • Orthopaedic Surgery Physician
  • Rockwall, TX
National Provider Identifier
1285728394
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
H9894 Issued in TX
Practice address
1005 W Ralph Hall Pkwy
Suite 237
Rockwall, TX 75032-6658
Phone
(972) 772-8577
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X H9894 TX Primary

Addresses

Primary practice location

1005 W Ralph Hall Pkwy
Suite 237
Rockwall, TX 75032-6658

Mailing address

PO Box 506
Rockwall, TX 75087-0506
Phone (972) 772-8577

Other identifiers 7

IdentifierTypeStateIssuer
096762204MedicaidTX
096762203MedicaidTX
200031546OtherTXPTAN RAILROAD
DR6492OtherTXPTAN RAILROAD
215761201MedicaidTX
0A5927OtherTXPTAN
8F23937OtherTXPTAN

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
I20100312000929 TX Practitioner - Orthopedic Surgery 8820051600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
H9894TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Apr 1, 2017 Accepting new patients
Hopkins County Hospital District Current Accepting new patients
Christus Trinity Clinic Texas Orthopaedic Surgery CurrentSince Apr 1, 2017 Accepting new patients
Rockwall Ambulatory Surgery Center LLP PastSince Apr 30, 2003 Accepting new patients

Locations

105 Medical Plz
Sulphur Springs, TX 75482
Phone (903) 885-3181

113 Airport Rd
Ste 200
Sulphur Springs, TX 75482
Phone (903) 439-2273

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 439-4052

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: michaeldu@direct.hcmh.md

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1285728394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750870506",
            "telephone_number": "972-772-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W RALPH HALL PKWY",
            "address_2": "SUITE 237",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326658",
            "telephone_number": "972-772-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCHAMP",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "H9894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096762204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096762203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN RAILROAD",
            "identifier": "200031546",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN RAILROAD",
            "identifier": "DR6492",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215761201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0A5927",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "8F23937",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.