Individual provider Active NPI

Bruce Jeffrey Applebaum, M.D.

  • Surgery Physician
  • Tyler, TX
National Provider Identifier
1902803679
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
J3278 Issued in TX
Practice address
630 S Fleishel Ave
Tyler, TX 75701-2041
Phone
(903) 606-5560
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X J3278 TX
Surgery Physician 208600000X J3278 TX Primary

Addresses

Primary practice location

630 S Fleishel Ave
Tyler, TX 75701-2041

Mailing address

14763 Big Oak Bay Rd
Tyler, TX 75707-7307
Phone (915) 474-4102

Other practice location 1

2000 Transmountain Rd Ste B
El Paso, TX 79911-3602
Phone (915) 215-5300

Other identifiers 1

IdentifierTypeStateIssuer
137411801MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071022000360 TX Practitioner - General Surgery 3476444290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Baylor College of Medicine, 1997
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)

2000 Trans Mountain Rd
Suite B
El Paso, TX 79911-3602
Phone (915) 215-8400

Hospital & facility affiliations

  • The Hospitals of Providence Transmountain Campus Hospital, El Paso, TX, CCN 670120
  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J3278TXMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Surgery CurrentSince Mar 1, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 12, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 12, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Mar 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Odessa Surgery Past Accepting new patients

Locations

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

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: bapplebaum294253@christushealth.direct-ci.net

Organizations & group practices 6

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 4

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1902803679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14763 BIG OAK BAY RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757077307",
            "telephone_number": "915-474-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012041",
            "telephone_number": "903-606-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Transmountain Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799113602",
            "country_code": "US",
            "telephone_number": "915-215-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "APPLEBAUM",
        "first_name": "BRUCE",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "J3278",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J3278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137411801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.