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

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: August 09, 2026.

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
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

Accepted 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

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.

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

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

Ascension Seton Hays

Acute Care Hospitals · Kyle, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670056
Location6001 Kyle PkwyKyle, TX 78640 · Hays County
Emergency services Birthing friendly

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
Quality58.54
Promoting Interoperability99
Improvement Activities40

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.

Orthopaedic Surgery (Sports Medicine)
12309 N MOPAC EXPY STE 150
AUSTIN, TX 78758
Physical Therapist
12309 N MOPAC EXPY STE 150
AUSTIN, TX 78758

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.

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 3 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 Ascension Seton Hays.

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 7 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.