NPIMap

Individual provider Active NPI

Eric Randall Brock, M.D.

  • Orthopaedic Surgery Physician
  • Mineral Wells, TX
National Provider Identifier
1396938973
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
N4311 Issued in TX
Practice address
715 W Hubbard St
Mineral Wells, TX 76067-4852
Phone
(940) 325-7900
Fax
(940) 325-7905
NPI assigned
Aug 27, 2007
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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 N4311 TX Primary

Addresses

Primary practice location

715 W Hubbard St
Mineral Wells, TX 76067-4852

Mailing address

715 W Hubbard St
Mineral Wells, TX 76067-4852
Phone (940) 325-7900

Other practice location 1

925 Santa Fe Dr Ste 113
Weatherford, TX 76086-5867
Phone (817) 901-9923

Other identifiers 1

IdentifierTypeStateIssuer
208674601MedicaidTX

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
I20091112000453 TX Practitioner - Orthopedic Surgery 3274671110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 W Hubbard St
Mineral Wells, TX 76067-4852
Phone (940) 325-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as individual
Quality
74.53
Promoting interoperability
99
Improvement activities
40
Cost
56.05

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N4311TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Brock, MD, Orthopedic Surgery, PA Orthopaedic Surgery CurrentSince Sep 15, 2009 Accepting new patients

Locations

715 W Hubbard St
Mineral Wells, TX 76067
Phone (940) 325-2526

925 Santa Fe Dr
Ste 113
Weatherford, TX 76086
Phone (817) 594-6232

Interoperability endpoints

  • Direct secure messaging: eric.brock.1@3085.direct.athenahealth.com

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 7

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": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1396938973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W HUBBARD ST",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760674852",
            "telephone_number": "940-325-7900",
            "fax_number": "940-325-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W HUBBARD ST",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760674852",
            "telephone_number": "940-325-7900",
            "fax_number": "940-325-7905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Santa Fe Dr Ste 113",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760865867",
            "country_code": "US",
            "telephone_number": "817-901-9923",
            "fax_number": "940-325-4280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ERIC",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "N4311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208674601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Wells, TX

Sources for this page

Verify at the official NPI Registry.