DR. ROBERT D GRAHAM II M.D.
NPI 1215935820
Orthopaedic Surgery in Austin, TX

Q: What is Robert Graham's NPI number?

The NPI number for Robert Graham is 1215935820. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Q: What is Robert Graham's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Robert Graham was last updated on August 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 July 08, 2005PECOS EnrolledAccepts Medicare Assignment

76.9/100

CMS Quality Rating

12309 N MOPAC EXPY STE 150, AUSTIN, TX 78758(512) 491-6404(512) 833-6716 Get Directions Write a Review

NPPES record last updated: August 27, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Robert D Graham Ii M.d. NPPES

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

DR. ROBERT D GRAHAM II M.D. (NPI 1215935820) is an individual orthopaedic surgery provider in Austin, Texas, licensed in Texas (L6404) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension Seton Medical Center Austin, and is a graduate of Duke University School Of Medicine (1997).

NPPES Registry Identity

NPI1215935820

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. ROBERT D GRAHAM IICredential: M.D.

Location Address12309 N MOPAC EXPY STE 150Austin, TX 78758

Mailing Address12309 N Mopac Expy Ste 150Austin, TX 78758-2647 · (512) 491-6404 · Fax (512) 833-6716

Phone(512) 491-6404

Fax(512) 833-6716

Sole ProprietorNo

Medical School CMSDuke University School Of MedicineGraduated 1997

Enumeration DateJuly 8, 2005

Last NPPES UpdateAugust 27, 2018

✔ NPI 1215935820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in TX · L6404

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.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License L6404 (TX)

12309 N MOPAC EXPY STE 150, Austin, TX 78758

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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert D Graham Ii M.d. 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 ID143278309

PECOS Enrollment IDI20050107000321

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 Robert Graham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Seton Family Of Doctors

1.2 mi

Family Medicine

3001 PALM WAY, D1 : 134-138
Austin, TX 78758

Reassigned Medicare billing, Texas enrollment
1,188 clinicians in this Medicare group

NPI 1225644065 (512) 324-5938

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

Areas of Expertise CMS Part B claims 14

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.

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.

305 services221 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.

111 services92 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.

82 services73 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.

77 services77 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.

61 services61 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

54 services54 patients

Computer-assisted surgery for muscle and bone procedure 20985

Computer-assisted surgery for muscle and bone procedures involves using a computer to aid in planning and performing surgery. This technology helps increase precision, reduce invasiveness, and improve outcomes. It's commonly used in orthopedic surgeries like joint replacements.

49 services49 patients

Anchoring of biceps tendon 23430

Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.

43 services43 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

32 services30 patients

Shaving of part of shoulder bone and repair of ligament using an endoscope 29826

This procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.

25 services25 patients

Repair of shoulder rotator cuff using an endoscope 29827

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

25 services25 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

19 services18 patients

Partial replacement of shoulder joint 23470

A partial shoulder joint replacement, also known as a hemiarthroplasty, involves replacing only the damaged part of the shoulder joint, typically the ball, while leaving the socket intact. This procedure can help reduce pain and improve function in the shoulder.

11 services11 patients

Removal of extensive shoulder joint tissue using an endoscope 29823

This procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension Seton Medical Center Austin

Acute Care Hospitals · Austin, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450056

Location1201 W 38th StAustin, TX 78705 · Travis County

Emergency services Birthing friendly

St David's Medical Center

Acute Care Hospitals · Austin, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450431

Location919 E 32nd StAustin, TX 78705 · Travis County

Emergency services Birthing friendly

Northwest Hills Surgical Hospital

Acute Care Hospitals · Austin, TX

OwnershipVoluntary non-profit - Private

CMS Certification Number450808

Location6818 Austin Ctr Blvd Suite 100Austin, TX 78731 · Travis County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78758 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

$89.03 typical visit price

range $57.88 – $174.00

Typical copayment $22.25 (range $14.47 – $43.50)

Most-billed visit code 99203

Established Patient

$71.95 typical visit price

range $18.88 – $142.23

Typical copayment $17.98 (range $4.72 – $35.55)

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.

76.9/100

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

Individually scored

Quality

58.54

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

13%591 patients1/55-star benchmark: 100%

Breast Cancer Screening

24%321 patients2/55-star benchmark: 93%

Cervical Cancer Screening

19%224 patients1/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

58%450 patients3/55-star benchmark: 87%

Colorectal Cancer Screening

16%810 patients1/55-star benchmark: 88%

Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older

0%67 patients1/55-star benchmark: 100%

Controlling High Blood Pressure

36%146 patients2/55-star benchmark: 91%

Diabetes: Eye Exam

5%38 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

68%38 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

7%1,817 patients1/55-star benchmark: 100%

e-Prescribing

100%1,040 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

4%568 patients1/55-star benchmark: 100%

HIV Screening

1%665 patients1/55-star benchmark: 60%

One-Time Screening for Hepatitis C Virus (HCV) for all Patients

4%489 patients1/55-star benchmark: 98%

Osteoporosis Management in Women Who Had a Fracture

15%27 patients

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

9%1,176 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

8%1,085 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%1,601 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 19% · 923 patients

18%923 patients

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Patients screened: 12% · 489 patients

11%489 patients

Provide Patients Electronic Access to Their Health Information

88%818 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

26%291 patients2/55-star benchmark: 98%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

76%135 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 595 patients

Patients totalRate: 30% · 596 patients

30%596 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.

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.

BURTON DENNARD DUNLAP M.D.

Orthopaedic Surgery (Sports Medicine)

12309 N MOPAC EXPY STE 150
AUSTIN, TX 78758

Travis County (512) 477-6341

ERICA HARMON DPT

Physical Therapist

12309 N MOPAC EXPY STE 150
AUSTIN, TX 78758

Travis County (512) 324-9170

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 Robert Graham's NPI number?

The NPI number for Robert Graham is 1215935820. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Where is Robert Graham located?

Robert Graham practices at 12309 N Mopac Expy Ste 150, Austin, TX 78758. The listed phone number is (512) 491-6404.

What is Robert Graham's specialty?

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

Is Robert Graham enrolled in Medicare?

Yes. Robert Graham 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.

Which organization bills Medicare for Robert Graham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Graham reassigns Medicare benefits to Seton Family Of Doctors (Austin, 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 Robert Graham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Graham 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 5 other insurers list Robert Graham 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 Robert Graham affiliated with any hospitals?

According to CMS data, Robert Graham is affiliated with Ascension Seton Medical Center Austin, St David's Medical Center and Northwest Hills Surgical Hospital.

When was this NPI record last updated?

The NPPES record for Robert Graham was last updated on August 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.