HUGH P BABINEAU MD
NPI 1043206774
Surgery in Tyler, TX

Q: What is Hugh Babineau's NPI number?

The NPI number for Hugh Babineau is 1043206774. It was assigned to this individual provider in the NPPES registry on September 27, 2005.

Q: What is Hugh Babineau's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Hugh Babineau was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 27, 2005PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

1100 E LAKE ST, STE 230, TYLER, TX 75701(903) 593-0230(903) 597-3015 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Hugh P Babineau Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HUGH P BABINEAU MD (NPI 1043206774) is an individual surgery provider in Tyler, Texas, licensed in Texas (L 1797) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of University Of Rochester School Of Medicine And Dentistry (1996).

NPPES Registry Identity

NPI1043206774

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameHUGH P BABINEAUCredential: MD

Location Address1100 E LAKE ST, STE 230Tyler, TX 75701-3343

Mailing Address1100 E Lake St, Ste 230Tyler, TX 75701-3343 · (903) 593-0230 · Fax (903) 597-3015

Phone(903) 593-0230

Fax(903) 597-3015

Sole ProprietorYes

Medical School CMSUniversity Of Rochester School Of Medicine And DentistryGraduated 1996

Enumeration DateSeptember 27, 2005

Last NPPES UpdateApril 28, 2008

✔ NPI 1043206774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in TX · L 1797

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

1100 E LAKE ST, Tyler, TX 75701

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Other Identifiers 4

Medicare UPINH42214

Medicaid1486250-01TX

Medicare PIN00Y577TX

Other8S2030TX · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hugh P Babineau Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022084599

PECOS Enrollment IDI20040907000473

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

35 services21 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

31 services30 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

24 services24 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

19 services18 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX

1/5 CMS rating

OwnershipProprietary

CMS Certification Number450083

Location1000 South Beckham AveTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Ut Health East Texas Jacksonville Hospital

Acute Care Hospitals · Jacksonville, TX

OwnershipProprietary

CMS Certification Number450194

Location501 S RagsdaleJacksonville, TX 75766 · Cherokee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY SUZANNE BAKER

Psychologist (Clinical)

1100 E LAKE ST
TYLER, TX 75701

Smith County (817) 734-4920

DR. JAMES T TURLINGTON MD

Urology

1100 E LAKE ST, SUITE 160
TYLER, TX 75701

Smith County (903) 590-5150

AZALEA INTERNAL MEDICINE ASSOCIATES PA

Internal Medicine

1100 E LAKE ST
TYLER, TX 75701

Smith County (903) 509-4100

MCCLINTOCK OBSTETRICS & GYNECOLOGY, P.A.

Obstetrics & Gynecology

1100 E LAKE ST, SUITE 260
TYLER, TX 75701

Smith County (903) 597-9400

HUGH P BABINEAU M D P A

Surgery

1100 E LAKE ST, SUITE 230
TYLER, TX 75701

Smith County (903) 593-0230

DR. CRAIG E HARRISON MD

Plastic Surgery

1100 E LAKE ST, SUITE 200
TYLER, TX 75701

Smith County (903) 535-7722

MEGAN FRANCIS

Nurse Practitioner (Family)

1100 E LAKE ST
TYLER, TX 75701

Smith County (903) 593-0230

JAMES T. CLARK M.D. P.A.

Plastic Surgery

1100 E LAKE ST, SUITE 330
TYLER, TX 75701

Smith County (903) 595-5522

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hugh Babineau's NPI number?

The NPI number for Hugh Babineau is 1043206774. It was assigned to this individual provider in the NPPES registry on September 27, 2005.

Where is Hugh Babineau located?

Hugh Babineau practices at 1100 E Lake St Ste 230, Tyler, TX 75701. The listed phone number is (903) 593-0230.

What is Hugh Babineau's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Hugh Babineau enrolled in Medicare?

Yes. Hugh Babineau is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Hugh Babineau accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Hugh Babineau as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Hugh Babineau affiliated with any hospitals?

According to CMS data, Hugh Babineau is affiliated with Ut Health East Texas Tyler Regional Hospital and Ut Health East Texas Jacksonville Hospital.

When was this NPI record last updated?

The NPPES record for Hugh Babineau was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.