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DR. ANDREW CHRISTIAN PELPHREY M.D.
NPI 1457301764
Internal Medicine - Nephrology in Austin, TX

Active since May 10, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
405 W 45TH ST, AUSTIN, TX 78751(512) 451-5800 Get Directions Write a Review

NPPES record last updated: April 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Andrew Christian Pelphrey M.d. NPPES

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

DR. ANDREW CHRISTIAN PELPHREY M.D. (NPI 1457301764) is an individual nephrology provider in Austin, Texas, licensed in Texas (L7518) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Dell Seton Med Center At The University Of Tx, and is a graduate of University Of Texas Southwestern Medical School At Dallas (2000).

NPPES Registry Identity

NPI1457301764
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. ANDREW CHRISTIAN PELPHREYCredential: M.D.
Location Address405 W 45TH STAustin, TX 78751-3013
Mailing Address405 W 45th StAustin, TX 78751-3013 · (512) 451-5800
Phone(512) 451-5800
Sole ProprietorNo
Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 2000
Enumeration DateMay 10, 2006
Last NPPES UpdateApril 5, 2023
NPPES CertifiedApril 5, 2023
✔ NPI 1457301764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in TX · L7518
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
405 W 45TH ST, Austin, TX 78751
Open in Google Maps ↗

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. Andrew Christian Pelphrey 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 ID3870598469
PECOS Enrollment IDI20061004000131
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 11

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.

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.
222 services84 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
178 services33 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.
148 services79 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.
124 services72 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.
74 services59 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
55 services22 patients

Hospital Affiliations CMS Care Compare 4

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

Dell Seton Med Center At The University Of Tx

Acute Care Hospitals · Austin, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450124
Location601 E 15th StreetAustin, TX 78701 · Travis County

St David's South Austin Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipProprietary
CMS Certification Number450713
Location901 West Ben White BlvdAustin, TX 78704 · Travis County
Emergency services Birthing friendly

Ascension Seton Williamson

Acute Care Hospitals · Round Rock, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670041
Location201 Seton ParkwayRound Rock, TX 78664 · Williamson 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 78751 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
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections
Percentage of patients, regardless of age, who undergo central venous catheter (CVC) insertion for whom CVC was inserted with all elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound…
100%48 patients
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 5

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
6 suppliers48 claims5,160 services$0.31 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers12 claims1,800 services$0.01 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers29 claims4,260 services$0.92 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
6 suppliers46 claims46 services$17.71 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
5 suppliers48 claims57 services$12.43 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Andrew Pelphrey's NPI number?

The NPI number for Andrew Pelphrey is 1457301764. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Where is Andrew Pelphrey located?

Andrew Pelphrey practices at 405 W 45th St, Austin, TX 78751. The listed phone number is (512) 451-5800.

What is Andrew Pelphrey's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Andrew Pelphrey enrolled in Medicare?

Yes. Andrew Pelphrey 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 Andrew Pelphrey 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 6 other insurers list Andrew Pelphrey 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 Andrew Pelphrey affiliated with any hospitals?

According to CMS data, Andrew Pelphrey is affiliated with Dell Seton Med Center At The University Of Tx, St David's South Austin Medical Center, Ascension Seton Williamson and Ascension Seton Hays.

When was this NPI record last updated?

The NPPES record for Andrew Pelphrey was last updated on April 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.