1. Home
  2. Directory
  3. Tennessee
  4. La Follette
  5. Orthopaedic Surgery
  6. NPI Profile

DR. MICHAEL PATRICK O'BRIEN M.D.
NPI 1528037710
Orthopaedic Surgery in La Follette, TN

Active since March 17, 2006PECOS EnrolledAccepts Medicare Assignment
91.5/100
CMS Quality Rating
919 E CENTRAL AVE STE 202, LA FOLLETTE, TN 37766(423) 907-1300(423) 907-1301 Get Directions Write a Review

NPPES record last updated: March 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael Patrick O'brien M.d. NPPES

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

DR. MICHAEL PATRICK O'BRIEN M.D. (NPI 1528037710) is an individual orthopaedic surgery provider in La Follette, Tennessee, licensed in Tennessee (MD37934) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Lafollette Medical Center, and is a graduate of Saint Louis University School Of Medicine (1994).

NPPES Registry Identity

NPI1528037710
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. MICHAEL PATRICK O'BRIENCredential: M.D.
Location Address919 E CENTRAL AVE STE 202La Follette, TN 37766-2778
Mailing Address919 E Central Ave Ste 202La Follette, TN 37766-2778 · (423) 907-1300 · Fax (423) 907-1301
Phone(423) 907-1300
Fax(423) 907-1301
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1994
Enumeration DateMarch 17, 2006
Last NPPES UpdateMarch 27, 2024
NPPES CertifiedMarch 27, 2024
✔ NPI 1528037710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in TN · MD37934
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
919 E CENTRAL AVE STE 202, La Follette, TN 37766
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health 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. Michael Patrick O'brien 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 ID42263998
PECOS Enrollment IDI20050302001061
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.

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.
46 services46 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
34 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
26 services26 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.
21 services18 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.
20 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Lafollette Medical Center

Acute Care Hospitals · La Follette, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440033
Location923 East Central AvenueLa Follette, TN 37766 · Campbell County
Emergency services

Physicians Regional Medical Center

Acute Care Hospitals · Powell, TN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number440120
Location7565 Dannaher Way PowellPowell, TN 37849 · Knox County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37766 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
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.

91.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability95
Improvement Activities40
Cost80.84

Reported Quality Measures

Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin
Percentage of surgical patients aged 18 years and older undergoing procedures with the indications for a first OR second generation cephalosporin prophylactic antibiotic, who had an order for a first OR second generation cephalosporin for antimicrobial…
100%28 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.

Other Providers at the Same Location NPPES

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

RACHEL LYN HOLLOWAY PA-C
Physician Assistant
919 E CENTRAL AVE STE 202
LA FOLLETTE, TN 37766
Campbell County (423) 907-1300

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 O'brien's NPI number?

The NPI number for Michael O'brien is 1528037710. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is Michael O'brien located?

Michael O'brien practices at 919 E Central Ave Ste 202, La Follette, TN 37766. The listed phone number is (423) 907-1300.

What is Michael O'brien's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Michael O'brien enrolled in Medicare?

Yes. Michael O'brien 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 O'brien accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list Michael O'brien 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 Michael O'brien affiliated with any hospitals?

According to CMS data, Michael O'brien is affiliated with Lafollette Medical Center and Physicians Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Michael O'brien was last updated on March 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.