JOSHUA N SPLINTER MD
NPI 1306109228
Internal Medicine in Athens, TX

Q: What is Joshua Splinter's NPI number?

The NPI number for Joshua Splinter is 1306109228. It was assigned to this individual provider in the NPPES registry on June 18, 2012.

Q: What is Joshua Splinter's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Joshua Splinter was last updated on November 16, 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.

Active since June 18, 2012PECOS EnrolledAccepts Medicare Assignment

63.38/100

CMS Quality Rating

117 MEDICAL CIR, ATHENS, TX 75751(903) 676-3200 Get Directions Write a Review

NPPES record last updated: November 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Joshua N Splinter Md NPPES

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

JOSHUA N SPLINTER MD (NPI 1306109228) is an individual internal medicine provider in Athens, Texas, licensed in Texas (P8546) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and maintains a secondary practice location in Marble Falls.

NPPES Registry Identity

NPI1306109228

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJOSHUA N SPLINTERCredential: MD

Location Address117 MEDICAL CIRAthens, TX 75751-9003

Mailing AddressPo Box 844658Dallas, TX 75284-4658

Phone(903) 676-3200

Sole ProprietorYes

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2012

Enumeration DateJune 18, 2012

Last NPPES UpdateNovember 16, 2018

✔ NPI 1306109228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TX · P8546

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X · License P8546 (TX), 53218 (TN)

117 MEDICAL CIR, Athens, TX 75751

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Secondary Practice Location 1

Location 1810 W Highway 71Marble Falls, TX 78654-8602 · Phone (830) 201-7100 · Fax (830) 201-7336

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

Joshua N Splinter 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 ID1355661158

PECOS Enrollment IDI20150519001099

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 26

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.

419 services145 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

282 services154 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

259 services151 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

257 services152 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

234 services152 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

173 services116 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.

104 services68 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

89 services89 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

66 services66 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

65 services65 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

64 services40 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

63 services40 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

36 services22 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

33 services30 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

33 services13 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

32 services31 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

31 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

31 services31 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

31 services31 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

28 services19 patients

Cyanocobalamin (vitamin b-12) level 82607

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

17 services16 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

16 services16 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

16 services16 patients

Screening mammography 77067

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

15 services15 patients

Screening 3d breast mammography 77063

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

12 services12 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX

1/5 CMS rating

OwnershipProprietary

CMS Certification Number450083

Location1000 South Beckham AveTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450102

Location800 East DawsonTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450389

Location2000 South Palestine StAthens, TX 75751 · Henderson County

Emergency services Birthing friendly

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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

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.

63.38/100

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

Scored as part of a group practice

Quality

85.71

Promoting Interoperability

Improvement Activities

Cost

75.54

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…

100%59 patients5/55-star benchmark: 100%

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

71%42 patients3/55-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 12

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

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers12 claims12 services$109.60 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers12 claims36 services$42.95 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

2 suppliers14 claims14 services$19.96 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers17 claims102 services$2.92 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier11 claims11 services$923.20 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers11 claims11 services$6.67 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 14

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

CHRISTIAN JOEL ZUNIGA D.O.

Family Medicine