NPIMap

Organization Active NPI

Orthopedic Associates of Flower Mound PLLC

  • Orthopaedic Surgery Physician
  • Northlake, TX
National Provider Identifier
1407528854
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC ASSOCIATES OF FLOWER MOUND PLLC
Practice address
1234 FM 407
Ste 100
North Lake, TX 76226
Phone
(972) 420-1776
Fax
(972) 221-8685
NPI assigned
Oct 4, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Jenny Bloebaum
Title
Ceo
Phone
(972) 420-1776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1234 FM 407
Ste 100
North Lake, TX 76226

Mailing address

5000 Long Prairie Rd Ste 100
Flower Mound, TX 75028-2783
Phone (972) 420-1776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211214000144 TX Part B Supplier - Clinic/Group Practice 2466842075 Receives reassigned benefits from 39 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Flower Mound, TX; Northlake, TX
O20220131002126 TX DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2466842075 Practice locations: Northlake, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1407528854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LONG PRAIRIE RD STE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282783",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FM 407",
            "address_2": "STE 100",
            "city": "NORTH LAKE",
            "state": "TX",
            "postal_code": "76226",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC ASSOCIATES OF FLOWER MOUND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "BLOEBAUM",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-420-1776"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.