NPIMap

Individual provider Active NPI

Walter C Brogan III, MD

  • Cardiovascular Disease Physician
  • Lubbock, TX
National Provider Identifier
1811069339
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
H9305 Issued in TX
Practice address
4802 N Loop 289
Lubbock, TX 79416-3025
Phone
(806) 788-0040
Fax
(806) 788-0015
NPI assigned
Nov 14, 2006
Last updated
Sep 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X H9305 TX Primary

Addresses

Primary practice location

4802 N Loop 289
Lubbock, TX 79416-3025

Mailing address

4802 N Loop 289
Lubbock, TX 79416-3025
Phone (806) 788-0040

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
I20050615000123 TX Practitioner - Cardiovascular Disease (Cardiology) 5092759613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
West Virginia University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seminole Hospital District of Gaines County TexasGroup PAC ID 2668382516, shared by 3 NPIs, 17 clinicians
Texas Physicians GroupGroup PAC ID 0042476582, 9 clinicians

Practice addresses (Care Compare)

209 NW 8TH St
Seminole, TX 79360-3447
Phone (915) 758-5811

4802 N Loop
Suite 289
Lubbock, TX 79416-3025
Phone (806) 788-0040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.78 of 100Reported as group
Quality
65.69
Promoting interoperability
100
Improvement activities
40
Cost
63.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting24
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Physicians Group Cardiovascular Disease CurrentSince Feb 1, 2015 Accepting new patients
Covenant Health System Past Accepting new patients

Locations

4802 N Loop 289
Lubbock, TX 79416
Phone (806) 788-0004

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24018/brand/1/csg/1/fhir/r4
  • Direct secure messaging: walter.brogan.1@24018.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1811069339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040",
            "fax_number": "806-788-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040",
            "fax_number": "806-788-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "WALTER",
        "middle_name": "C",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "H9305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.