Individual provider Active NPI

Philip E Fidler, M.D.

  • Surgery Physician
  • Plano, TX
National Provider Identifier
1689643637
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R8186 Issued in TX
Practice address
1600 Coit Rd Ste 305
Plano, TX 75075-6172
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 19524 NV
Surgical Critical Care Physician 2086S0102X R8186 TX
Surgical Critical Care Physician 2086S0102X 0101273072 VA
Surgical Critical Care Physician 2086S0102X 10838A WY
Surgical Critical Care Physician 2086S0102X ME152606 FL
Surgical Critical Care Physician 2086S0102X CDRH.0055039 CO
Surgical Critical Care Physician 2086S0102X MD0000064204 TN
Surgical Critical Care Physician 2086S0102X MC-0432 ID
Surgical Critical Care Physician 2086S0102X 73960 GA
Surgical Critical Care Physician 2086S0102X 27572 MS
Surgery Physician 208600000X R8186 TX Primary

Addresses

Primary practice location

1600 Coit Rd Ste 305
Plano, TX 75075-6172

Mailing address

PO Box 12187
Augusta, GA 30914-2187
Phone (706) 863-9595

Other practice location 1

3901 W 15th St
Plano, TX 75075-7738
Phone (706) 863-9595

Other practice location 2

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (855) 863-9595

Other practice location 3

13472 Eastlake Blvd Ste A
Horizon City, TX 79928-6320
Phone (915) 313-6300

Other practice location 4

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MS, AZ, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180808001014 TX Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 9739241118 Reassigns benefits to 2 organizations
I20210614000539 MS Practitioner - General Surgery 9739241118 Reassigns benefits to 1 organization
I20230612000404 AZ Practitioner - General SurgeryPractitioner - Other (Physician) 9739241118 Reassigns benefits to 1 organization
I20241203000816 NY Practitioner - General Surgery 9739241118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME152606FLMDSurgical Critical Care Physician
73960GAMDSurgical Critical Care Physician
MC-0432IDMDSurgical Critical Care Physician
MD0000064204TNMDSurgical Critical Care Physician
10838AWYMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Surgery CurrentSince Jun 1, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Mississippi Burn, Hand and Reconstruction Centers PC Surgery CurrentSince Jan 25, 2025 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jun 1, 2025 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Sep 18, 2024 Accepting new patients
District Medical Group, Inc CurrentSince May 1, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
District Medical Group, Inc CurrentSince May 1, 2023 Accepting new patients
Texas Tech University Health Sciences Center Odessa Family Medicine Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1225 N State St
Ste 103
Jackson, MS 39202
Phone (769) 268-6520

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Interoperability endpoints

  • Direct secure messaging: pfidler255990@direct.valleywisehealth.org

Organizations & group practices 10

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 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1689643637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12187",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309142187",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 COIT RD STE 305",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756172",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 W 15th St",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750757738",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Chadwick Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392043404",
            "country_code": "US",
            "telephone_number": "855-863-9595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13472 Eastlake Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Horizon City",
            "state": "TX",
            "postal_code": "799286320",
            "country_code": "US",
            "telephone_number": "915-313-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5300",
            "fax_number": "915-215-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "PHILIP",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "19524",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "R8186",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "VA",
            "license": "0101273072",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WY",
            "license": "10838A",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME152606",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CO",
            "license": "CDRH.0055039",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TN",
            "license": "MD0000064204",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "MC-0432",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "73960",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MS",
            "license": "27572",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "R8186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.