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DR. JEFFREY W. FIDONE M.D.
NPI 1316945694
Internal Medicine - Critical Care Medicine in Tyler, TX

Active since July 12, 2005PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
15210 COUNTY ROAD 164, TYLER, TX 75703(903) 571-1985 Get Directions Write a Review

NPPES record last updated: August 1, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 1, 2019, May 10, 2019, Jan 7, 2019 (3 updates tracked since 2019).

About Dr. Jeffrey W. Fidone M.d. NPPES

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

DR. JEFFREY W. FIDONE M.D. (NPI 1316945694) is an individual critical care medicine provider in Tyler, Texas, licensed in Indiana (01080093A) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Research Medical Center, and maintains a secondary practice location in Fort Wayne.

NPPES Registry Identity

NPI1316945694
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDR. JEFFREY W. FIDONECredential: M.D.
Location Address15210 COUNTY ROAD 164Tyler, TX 75703
Mailing Address15210 County Road 164Tyler, TX 75703 · (903) 571-1985
Phone(903) 571-1985
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateJuly 12, 2005
Last NPPES UpdateAugust 1, 20193 updates tracked since enumeration
✔ NPI 1316945694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
Licenses✔ Licensed in IN · 01080093A✔ Licensed in TX · H6215✔ Licensed in OK · 31842
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License H6215 (TX)
15210 COUNTY ROAD 164, Tyler, TX 75703
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Secondary Practice Location 1

Location 111104 Parkview Circle Dr Ste 410Fort Wayne, IN 46845-0025 · Phone (260) 266-5260 · Fax (260) 266-5279

Other Identifiers 2

Other290005858TX · Rr Mc
Medicaid102165102TX

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

Dr. Jeffrey W. Fidone 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 ID446164859
PECOS Enrollment IDI20041023000239, I20240921000473
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 5

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
241 services98 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.
72 services55 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.
26 services24 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.
18 services18 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.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Research Medical Center

Acute Care Hospitals · Kansas City, MO
2/5 CMS rating
OwnershipProprietary
CMS Certification Number260027
Location2316 E Meyer BlvdKansas City, MO 64132 · Jackson County
Emergency services Birthing friendly

Chi St Lukes Health Memorial Lufkin

Acute Care Hospitals · Lufkin, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450211
Location1201 West Frank StreetLufkin, TX 75901 · Angelina County
Emergency services Birthing friendly

Nacogdoches Medical Center

Acute Care Hospitals · Nacogdoches, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450656
Location4920 NE Stallings DriveNacogdoches, TX 75965 · Nacogdoches County
Emergency services Birthing friendly

Longview Regional Medical Center

Acute Care Hospitals · Longview, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450702
Location2901 N Fourth StLongview, TX 75605 · Gregg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75703 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.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.04
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…
100%26 patients5/55-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.

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 Jeffrey Fidone's NPI number?

The NPI number for Jeffrey Fidone is 1316945694. It was assigned to this individual provider in the NPPES registry on July 12, 2005.

Where is Jeffrey Fidone located?

Jeffrey Fidone practices at 15210 County Road 164, Tyler, TX 75703. The listed phone number is (903) 571-1985.

What is Jeffrey Fidone's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Jeffrey Fidone enrolled in Medicare?

Yes. Jeffrey Fidone 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 Jeffrey Fidone 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 Jeffrey Fidone 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 Jeffrey Fidone affiliated with any hospitals?

According to CMS data, Jeffrey Fidone is affiliated with Research Medical Center, Chi St Lukes Health Memorial Lufkin, Nacogdoches Medical Center and Longview Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Jeffrey Fidone was last updated on August 1, 2019. 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.