NPIMap

Individual provider Active NPI

Shane T Seroyer, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Arlington, TX
National Provider Identifier
1487857892
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
N1887 Issued in TX
Practice address
3533 Matlock Road
Arlington, TX 76015-3604
Phone
(817) 419-0303
Fax
(817) 468-5963
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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 N1887 TX
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X N1887 TX Primary

Addresses

Primary practice location

3533 Matlock Road
Arlington, TX 76015-3604

Mailing address

3533 Matlock Road
Arlington, TX 76015-3604
Phone (817) 419-0303

Other practice location 1

76 Regency Pkwy
Mansfield, TX 76063-7816
Phone (817) 419-0303

Other identifiers 1

IdentifierTypeStateIssuer
204613801MedicaidTX

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
I20090813000813 TX Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Other (Physician) 8820162217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Florida College of Medicine, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Tmi Sports Medicine and Orthopedic Surgery PAGroup PAC ID 1052399508, 19 clinicians

Practice addresses (Care Compare)

3533 Matlock Rd
Arlington, TX 76015-3604
Phone (817) 419-0303

Hospital & facility affiliations

  • Home Health Professionals Dallas Home health agency, Dallas, TX, CCN 457812
  • Vitalcaring Group Home health agency, Ft Worth, TX, CCN 677132
  • Vitalcaring Group Home health agency, Sulphur Springs, TX, CCN 679076
  • Encompass Home Health of DFW Home health agency, Grapevine, TX, CCN 679428
  • Enhabit Home Health Home health agency, Fort Worth, TX, CCN 679167
  • Baylor Surgical Hospital at Las Colinas Hospital, Irving, TX, CCN 450874
  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Merit-based Incentive Payment System (MIPS)

Final score
82.82 of 100Reported as individual
Quality
68.07
Promoting interoperability
100
Improvement activities
40
Cost
74.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement18
Knee replacement171
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1887TXMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tmi Sports Medicine and Orthopedic Surgery PA Orthopaedic Surgery CurrentSince Jan 1, 2015 Accepting new patients
Tmi Sports Medicine and Orthopedic Surgery PA Orthopaedic Surgery CurrentSince Jan 1, 2015 Accepting new patients
Midwest Orthopaedics at Rush, LLC Orthopaedic Surgery Past Accepting new patients

Locations

3533 Matlock Rd
Arlington, TX 76015
Phone (817) 419-0303

515 W Mayfield Rd
Ste 116
Arlington, TX 76014
Phone (817) 419-0303

76 Regency Pkwy
Mansfield, TX 76063
Phone (817) 419-0303

Interoperability endpoints

  • Direct secure messaging: shane.seroyer.1@25955.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1487857892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 MATLOCK ROAD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153604",
            "telephone_number": "817-419-0303",
            "fax_number": "817-468-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 MATLOCK ROAD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153604",
            "telephone_number": "817-419-0303",
            "fax_number": "817-468-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Regency Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760637816",
            "country_code": "US",
            "telephone_number": "817-419-0303",
            "fax_number": "833-626-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEROYER",
        "first_name": "SHANE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "N1887",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "N1887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204613801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.