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MR. KEVIN LEE FAIN MD
NPI 1174511281
Orthopaedic Surgery in Athens, TX

Active since October 12, 2005PECOS Enrolled
97.58/100
CMS Quality Rating
1123 S PALESTINE ST, ATHENS, TX 75751(903) 675-9526(903) 677-1815 Get Directions Write a Review

NPPES record last updated: January 5, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Kevin Lee Fain Md NPPES

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

MR. KEVIN LEE FAIN MD (NPI 1174511281) is an individual orthopaedic surgery provider in Athens, Texas, licensed in Texas (H3878) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174511281
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameMR. KEVIN LEE FAINCredential: MD
Location Address1123 S PALESTINE STAthens, TX 75751-3646
Mailing Address1123 S Palestine StAthens, TX 75751-3646 · (903) 675-9526 · Fax (903) 677-1815
Phone(903) 675-9526
Fax(903) 677-1815
Sole ProprietorNo
Enumeration DateOctober 12, 2005
Last NPPES UpdateJanuary 5, 2017
✔ NPI 1174511281 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 · H3878
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.
1123 S PALESTINE ST, Athens, TX 75751
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Other Identifiers 6

Medicare PIN8L7051TX
Medicare UPINE04497
Medicare PIN8948K0TX
Other200039355Railroad Medicare
Medicaid131305806TX
Other8948K0TX · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kevin Lee Fain Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Fain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Etmc Physician Group Inc.
34 mi
Cardiovascular Disease
1000 S BECKHAM AVE
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • 636 clinicians in this Medicare group
NPI 1609382662 (903) 590-5611

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75751 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
Quality86.53
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
85%92 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%300 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
82%140 patients4/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%459 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
78%746 patients4/55-star benchmark: 100%
Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
Percentage of surgical patients aged 18 years and older undergoing procedures for which venous thromboembolism (VTE) prophylaxis is indicated in all patients, who had an order for Low Molecular Weight Heparin (LMWH), Low- Dose Unfractionated Heparin (LDUH)…
100%28 patients
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 39 patients
Patients tobacco: 49% · 148 patients
100%39 patients5/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%746 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
4%746 patients1/55-star benchmark: 79%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
87%104 patients
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 81 patients
1%81 patients4/55-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.

Other Providers at the Same Location NPPES 3

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

ATHENS FOOT AND ANKLE HEALTH AND SURGERY, PC
Durable Medical Equipment & Medical Supplies
1123 S PALESTINE ST, SUITE 200
ATHENS, TX 75751
Henderson County (903) 675-1337
ATHENS ORTHOPEDIC AND PHYSICAL THERAPY CENTER PA
Orthopaedic Surgery
1123 S PALESTINE ST
ATHENS, TX 75751
Henderson County (903) 675-9526
EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES
Durable Medical Equipment & Medical Supplies
1123 S PALESTINE ST
ATHENS, TX 75751
Henderson County (903) 675-9526

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 Kevin Fain's NPI number?

The NPI number for Kevin Fain is 1174511281. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Kevin Fain located?

Kevin Fain practices at 1123 S Palestine St, Athens, TX 75751. The listed phone number is (903) 675-9526.

What is Kevin Fain's specialty?

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

Is Kevin Fain enrolled in Medicare?

Yes. Kevin Fain is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Fain's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Fain reassigns Medicare benefits to Etmc Physician Group Inc. (Tyler, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Fain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Fain accept?

Health plans from Blue Cross and Blue Shield of Texas list Kevin Fain 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.

When was this NPI record last updated?

The NPPES record for Kevin Fain was last updated on January 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.