DR. ADAM MICHAEL FALCONE M.D.
NPI 1558534958
Internal Medicine - Interventional Cardiology in Waco, TX

Active since April 07, 2008PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
7125 NEW SANGER AVE STE A, WACO, TX 76712(254) 399-5400(254) 772-8669 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 3, 2026, Nov 24, 2025, Sep 9, 2024 and 7 more (10 updates tracked since 2016).

About Dr. Adam Michael Falcone M.d. NPPES

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

DR. ADAM MICHAEL FALCONE M.D. (NPI 1558534958) is an individual interventional cardiology provider in Waco, Texas, licensed in Texas (N8781) and active in the NPI registry since April 2008. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence, and is a graduate of University Of Texas Medical Branch At Galveston (2008).

NPPES Registry Identity

NPI1558534958
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameDR. ADAM MICHAEL FALCONECredential: M.D.
Location Address7125 NEW SANGER AVE STE AWaco, TX 76712-4054
Mailing AddressPo Box 21327Waco, TX 76702-1327 · (254) 399-5400
Fax(254) 772-8669
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2008
Enumeration DateApril 7, 2008
Last NPPES UpdateMarch 3, 202610 updates tracked since enumeration
NPPES CertifiedMarch 3, 2026
NPI 1558534958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License Licensed in TX · N8781
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License N8781 (TX)
7125 NEW SANGER AVE STE A, Waco, TX 76712

Accepted 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. Adam Michael Falcone 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 ID6305001355
PECOS Enrollment IDI20120626000297
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 37

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.
948 services727 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
697 services646 patients
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487
Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
623 services201 patients
Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
372 services93 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
251 services71 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
200 services73 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension Providence

Acute Care Hospitals · Waco, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450042
Location6901 Medical ParkwayWaco, TX 76712 · Mc Lennan County
Emergency services Birthing friendly

Baylor Scott & White Medical Center Hillcrest

Acute Care Hospitals · Waco, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450101
Location100 Hillcrest Medical BlvdWaco, TX 76712 · Mc Lennan County
Emergency services Birthing friendly

Coryell Memorial Hospital

Critical Access Hospitals · Gatesville, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451379
Location1507 W Main StreetGatesville, TX 76528 · Coryell County
Emergency services

Goodall Witcher Hospital

Critical Access Hospitals · Clifton, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451385
Location101 Posey AvenueClifton, TX 76634 · Bosque County
Emergency services Birthing friendly

Hamilton General Hospital

Critical Access Hospitals · Hamilton, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451392
Location400 N Brown, Building 1Hamilton, TX 76531 · Hamilton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76712 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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
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…
98%1,367 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
96%2,753 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
94%5,528 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
55%20 patients3/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%630 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
76%2,201 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
80%2,218 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
4%2,218 patients1/55-star benchmark: 79%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
73%2,026 patients4/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 1,214 patients
1%1,214 patients4/55-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.

Other Providers at the Same Location NPPES 19

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

Internal Medicine (Clinical Cardiac Electrophysiology)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Nurse Practitioner (Family)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Internal Medicine (Clinical Cardiac Electrophysiology)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Nurse Practitioner (Family)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Internal Medicine (Cardiovascular Disease)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Physician Assistant
7125 NEW SANGER AVE STE A
WACO, TX 76712
Internal Medicine (Cardiovascular Disease)
7125 NEW SANGER AVE STE A
WACO, TX 76712
Internal Medicine (Interventional Cardiology)
7125 NEW SANGER AVE STE A
WACO, TX 76712

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 Adam Falcone's NPI number?

The NPI number for Adam Falcone is 1558534958. It was assigned to this individual provider in the NPPES registry on April 7, 2008.

Where is Adam Falcone located?

Adam Falcone practices at 7125 New Sanger Ave Ste A, Waco, TX 76712. The listed phone number is (254) 399-5400.

What is Adam Falcone's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Adam Falcone enrolled in Medicare?

Yes. Adam Falcone 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 Adam Falcone 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 2 other insurers list Adam Falcone 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 Adam Falcone affiliated with any hospitals?

According to CMS data, Adam Falcone is affiliated with Ascension Providence, Baylor Scott & White Medical Center Hillcrest, Coryell Memorial Hospital, Goodall Witcher Hospital and Hamilton General Hospital.

When was this NPI record last updated?

The NPPES record for Adam Falcone was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.