STEPHEN M SEPULVEDA MD
NPI 1356601611
Family Medicine in Tyler, TX

Q: What is Stephen Sepulveda's NPI number?

The NPI number for Stephen Sepulveda is 1356601611. It was assigned to this individual provider in the NPPES registry on May 21, 2012.

Q: What is Stephen Sepulveda's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Sepulveda was last updated on May 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 May 21, 2012PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

11937 US HIGHWAY 271, TYLER, TX 75708(903) 877-7200(903) 877-5080 Get Directions Write a Review

NPPES record last updated: May 7, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Stephen M Sepulveda Md NPPES

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

STEPHEN M SEPULVEDA MD (NPI 1356601611) is an individual family medicine provider in Tyler, Texas, licensed in Texas (Q2850) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of University Of Texas Southwestern Medical School At Dallas (2011).

NPPES Registry Identity

NPI1356601611

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSTEPHEN M SEPULVEDACredential: MD

Location Address11937 US HIGHWAY 271Tyler, TX 75708-3154

Mailing AddressPo Box 731912Dallas, TX 75373-1912 · (903) 877-7200 · Fax (903) 877-5080

Phone(903) 877-7200

Fax(903) 877-5080

Sole ProprietorNo

Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 2011

Enumeration DateMay 21, 2012

Last NPPES UpdateMay 7, 2015

✔ NPI 1356601611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in TX · Q2850✔ Licensed in TX · BP1-0044181

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

11937 US HIGHWAY 271, Tyler, TX 75708

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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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephen M Sepulveda 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 ID3375863970

PECOS Enrollment IDI20150521002375

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.

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.

205 services123 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

132 services19 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.

97 services79 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.

67 services67 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.

24 services24 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

Ut Health East Texas Henderson Hospital

Acute Care Hospitals · Henderson, TX

OwnershipProprietary

CMS Certification Number450475

Location300 Wilson StreetHenderson, TX 75652 · Rusk County

Emergency services Birthing friendly

The University Of Texas Health Science Center At Tyler

Acute Care Hospitals · Tyler, TX

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number450690

Location11937 Us Highway 271Tyler, TX 75708 · Smith County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75708 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

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.

97.58/100

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

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers20 claims68 services$6.91 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

2 suppliers12 claims12 services$15.11 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 20

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

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER

Psychiatric Unit