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ADHAM A ABDELFATTAH MD
NPI 1073833026
Orthopaedic Surgery in San Antonio, TX

Active since June 01, 2010PECOS EnrolledAccepts Medicare Assignment
49.32/100
CMS Quality Rating
3903 WISEMAN BLVD STE 213, SAN ANTONIO, TX 78251(210) 680-1000(210) 680-1003 Get Directions Write a Review

NPPES record last updated: August 23, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 23, 2019, Aug 9, 2019, Nov 17, 2016 and 1 more (4 updates tracked since 2016).

About Adham A Abdelfattah Md NPPES

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

ADHAM A ABDELFATTAH MD (NPI 1073833026) is an individual orthopaedic surgery provider in San Antonio, Texas, licensed in Texas (R3782) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Baptist Medical Center, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2010).

NPPES Registry Identity

NPI1073833026
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameADHAM A ABDELFATTAHCredential: MD
Location Address3903 WISEMAN BLVD STE 213San Antonio, TX 78251-4417
Mailing Address3903 Wiseman Blvd Ste 213San Antonio, TX 78251-4417 · (210) 680-1000 · Fax (210) 680-1003
Phone(210) 680-1000
Fax(210) 680-1003
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2010
Enumeration DateJune 1, 2010
Last NPPES UpdateAugust 23, 20194 updates tracked since enumeration
✔ NPI 1073833026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in TX · R3782
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
3903 WISEMAN BLVD STE 213, San Antonio, TX 78251
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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

Adham A Abdelfattah 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 ID2062715477
PECOS Enrollment IDI20170906000854
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 8

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
1,200 services64 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.
278 services140 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
121 services66 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.
107 services69 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
79 services79 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
54 services33 patients

Hospital Affiliations CMS Care Compare 2

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

Baptist Medical Center

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450058
Location111 Dallas StreetSan Antonio, TX 78205 · Bexar County
Emergency services Birthing friendly

Legent Orthopedic + Spine

Acute Care Hospitals · San Antonio, TX
OwnershipProprietary
CMS Certification Number670112
Location5330 North Loop 1604 WestSan Antonio, TX 78249 · Bexar County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78251 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.

49.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality37.31
Promoting Interoperability71
Improvement Activities20

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
0%104 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
96%3,063 patients4/55-star benchmark: 100%
e-Prescribing
100%114 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
19%1,457 patients1/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
27%3,063 patients2/55-star benchmark: 100%
Support Electronic Referral Loops By Sending Health Information
5%21 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L1832
DME-Orthotic Devices · category DF011N
1 supplier12 claims13 services$470.92 avg. paid by Medicare
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment L3960
DME-Orthotic Devices · category DF000N
2 suppliers14 claims14 services$676.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

INSTITUTE OF ORTHOPAEDIC SPECIAL SURGERY
Orthopaedic Surgery
3903 WISEMAN BLVD STE 213
SAN ANTONIO, TX 78251
Bexar County (210) 680-1000
DR. SEAN SHAHRESTANI M.D.
Orthopaedic Surgery
3903 WISEMAN BLVD STE 213
SAN ANTONIO, TX 78251
Bexar County (210) 680-1000

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 Adham Abdelfattah's NPI number?

The NPI number for Adham Abdelfattah is 1073833026. It was assigned to this individual provider in the NPPES registry on June 1, 2010.

Where is Adham Abdelfattah located?

Adham Abdelfattah practices at 3903 Wiseman Blvd Ste 213, San Antonio, TX 78251. The listed phone number is (210) 680-1000.

What is Adham Abdelfattah's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Adham Abdelfattah enrolled in Medicare?

Yes. Adham Abdelfattah 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 Adham Abdelfattah 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 3 other insurers list Adham Abdelfattah 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 Adham Abdelfattah affiliated with any hospitals?

According to CMS data, Adham Abdelfattah is affiliated with Baptist Medical Center and Legent Orthopedic + Spine.

When was this NPI record last updated?

The NPPES record for Adham Abdelfattah was last updated on August 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.