MICHAEL T BREEN M.D.
NPI 1225190259
Obstetrics & Gynecology in Austin, TX

Active since December 15, 2006PECOS EnrolledAccepts Medicare Assignment
71.53/100
CMS Quality Rating
911 W 38TH ST, SUITE 202, AUSTIN, TX 78705(512) 324-8670(512) 380-7531 Get Directions Write a Review

NPPES record last updated: October 9, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael T Breen M.d. NPPES

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

MICHAEL T BREEN M.D. (NPI 1225190259) is an individual obstetrics & gynecology provider in Austin, Texas, licensed in Texas (F9233) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical Branch At Galveston (1981).

NPPES Registry Identity

NPI1225190259
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameMICHAEL T BREENCredential: M.D.
Location Address911 W 38TH ST, SUITE 202Austin, TX 78705-1188
Mailing Address1601 Rio Grande St, Suite 340Austin, TX 78701-1137 · (512) 324-8960
Fax(512) 380-7531
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 1981
Enumeration DateDecember 15, 2006
Last NPPES UpdateOctober 9, 2015
NPI 1225190259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License Licensed in TX · F9233
Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

911 W 38TH ST, Austin, TX 78705

Other Identifiers 3

Medicare UPINC13735TX
Medicaid131088009TX
Medicare PIN8L14614TX

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

Michael T Breen 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 ID4385691864
PECOS Enrollment IDI20060130000273
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 2

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 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.
29 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.
16 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78705 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
$131.95 typical visit price
range $57.88 – $174.00
Typical copayment $32.98 (range $14.47 – $43.50)
Most-billed visit code 99204
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.

71.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.85
Improvement Activities40
Cost69.55

Reported Quality Measures

Breast Cancer Screening
84%284 patients4/55-star benchmark: 93%
Cervical Cancer Screening
95%607 patients4/55-star benchmark: 98%
Chlamydia Screening for Women
13%90 patients
Closing the Referral Loop: Receipt of Specialist Report
37%191 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
53%440 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
57%76 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
4%23 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
70%23 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
99%1,418 patients4/55-star benchmark: 100%
e-Prescribing
99%997 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
5%92 patients1/55-star benchmark: 100%
HIV Screening
29%805 patients2/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
40%797 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
12%756 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
35%1,203 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 76% · 741 patients
Patients screened: 78% · 741 patients
43%28 patients2/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
96%541 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
57%81 patients2/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 103 patients
Patients totalRate: 5% · 103 patients
4%103 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 11

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

Clinical Nurse Specialist (Gerontology)
911 W 38TH ST, SUITE 200
AUSTIN, TX 78705
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
911 W 38TH ST, SUITE 202
AUSTIN, TX 78705
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
911 W 38TH ST, SUITE 202
AUSTIN, TX 78705
Nurse Practitioner (Family)
911 W 38TH ST, SUITE 202
AUSTIN, TX 78705
Acupuncturist
911 W 38TH ST, 200T
AUSTIN, TX 78705
Clinical Nurse Specialist (Perinatal)
911 W 38TH ST, SUITE 201
AUSTIN, TX 78705
Obstetrics & Gynecology (Gynecologic Oncology)
911 W 38TH ST, SUITE 202
AUSTIN, TX 78705
Advanced Practice Midwife
911 W 38TH ST, SUITE 202
AUSTIN, TX 78705

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 Michael Breen's NPI number?

The NPI number for Michael Breen is 1225190259. It was assigned to this individual provider in the NPPES registry on December 15, 2006.

Where is Michael Breen located?

Michael Breen practices at 911 W 38th St Suite 202, Austin, TX 78705. The listed phone number is (512) 324-8670.

What is Michael Breen's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Michael Breen enrolled in Medicare?

Yes. Michael Breen 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 Michael Breen 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 Michael Breen 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 Michael Breen was last updated on October 9, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.