Robert Bryan Dorman, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

S4461 Issued in TX

Practice address

115 Medical Cir Ste 107
Athens, TX 75751-9004

Phone

(903) 675-5781

Fax

(903) 677-1008

NPI assigned

Apr 20, 2009

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

General Surgery

Education

University of Arkansas College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdorman491150@directb.mercy.net
• Direct secure messaging: rdorman497021@directa.mercy.net
• Direct secure messaging: rdorman355005@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Healogics Specialty Physicians of Texas, PLLC

  • Surgery Physician
  • Allen, TX
  • NPI 1285051094
  Medicare reassignment NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Jay, OK
  • NPI 1659388965
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD
• Jacksonville Hospital LLC

  • Rural Health Clinic/Center
  • Jacksonville, TX
  • NPI 1861991226
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Jacksonville Hospital LLC

  dba UTHealth East Texas Jacksonville Hospital

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1740423839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S HORSEBARN RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588237",
            "telephone_number": "479-271-9607",
            "fax_number": "479-271-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR STE 107",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519004",
            "telephone_number": "903-675-5781",
            "fax_number": "903-677-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 S Horsebarn Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588237",
            "country_code": "US",
            "telephone_number": "479-271-9607",
            "fax_number": "479-271-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "ROBERT",
        "middle_name": "BRYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-8173",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S4461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard T David, MD
• Hunter Christian Davis
• Latoria D Davis, FNP-C
• DCS Medical PA
• Heather Diann Derosa-Cain
• Scott Walton Dowlearn, D.D.S.
• Shannon Drohn
• East Texas Anesthesia Associates, PA
• East Texas Community Clinic, Inc.
• East Texas Community Clinic, Inc. (East Texas Community Clinic Pharmacy)

• Surgery Physician in Athens, TX
• Providers in Athens, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.