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ROY A SETZENFAND MD
NPI 1659305696
Internal Medicine in Carrollton, TX

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment
1213 E TRINITY MILLS RD STE 173, CARROLLTON, TX 75006(972) 962-1296(469) 340-4129 Get Directions Write a Review

NPPES record last updated: May 17, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Roy A Setzenfand Md NPPES

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

ROY A SETZENFAND MD (NPI 1659305696) is an individual internal medicine provider in Carrollton, Texas, licensed in Texas (L8947) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, maintains 9 additional practice locations, and is a graduate of Hahnemann University College Of Medicine (1994).

NPPES Registry Identity

NPI1659305696
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameROY A SETZENFANDCredential: MD
Location Address1213 E TRINITY MILLS RD STE 173Carrollton, TX 75006-1446
Mailing AddressPo Box 746079Atlanta, GA 30374-6079 · (312) 733-9730 · Fax (773) 866-8014
Phone(972) 962-1296
Fax(469) 340-4129
Sole ProprietorNo
Medical School CMSHahnemann University College Of MedicineGraduated 1994
Enumeration DateJuly 10, 2006
Last NPPES UpdateMay 17, 2022
NPPES CertifiedMay 17, 2022
✔ NPI 1659305696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · L8947
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1213 E TRINITY MILLS RD STE 173, Carrollton, TX 75006
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Secondary Practice Locations 9

Location 14510 Medical Center Dr, Suite 311McKinney, TX 75069-1650 · Phone (972) 540-6256 · Fax (972) 540-5071
Location 21950 Ephriham AveFort Worth, TX 76164-6670 · Phone (817) 813-7075 · Fax (817) 764-0656
Location 31515 S Buckner Blvd Ste 141Dallas, TX 75217-1794 · Phone (214) 305-7065 · Fax (469) 574-0383
Location 48840 Benbrook Blvd Ste 101Benbrook, TX 76126-2173 · Phone (817) 813-7101 · Fax (817) 382-5458
Location 54801 S Cooper St Ste 401Arlington, TX 76017-5963 · Phone (817) 813-7100 · Fax (817) 382-5458
Location 64115 E Lancaster AveFort Worth, TX 76103-3614 · Phone (817) 796-7370 · Fax (817) 764-0714
Location 72110 N Galloway Ave Ste 116Mesquite, TX 75150-5737 · Phone (972) 426-5426 · Fax (459) 646-8812
Location 82928 N Belt Line RdIrving, TX 75062-5247 · Phone (214) 307-7786 · Fax (469) 460-9091
Location 92360 Gus Thomasson RdDallas, TX 75228-3005 · Phone (214) 301-7071 · Fax (469) 535-8772

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roy A Setzenfand 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 ID1557356011
PECOS Enrollment IDI20040714000530
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.

Medicare Billing Reassignment

Medicare enrollment records show Roy Setzenfand reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Oak Street Health Of Texas, PLLC
27 mi
Primary Care
4115 E LANCASTER AVE
Fort Worth, TX 76103
  • Reassigned Medicare billing, Texas enrollment
  • 175 clinicians in this Medicare group
NPI 1497387419 (312) 733-9730

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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 straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
64 services51 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.
18 services18 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75006 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
$131.01 typical visit price
range $57.18 – $172.86
Typical copayment $32.75 (range $14.29 – $43.21)
Most-billed visit code 99204
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

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
8 suppliers12 claims48 services$5.52 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers12 claims12 services$14.14 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier11 claims11 services$4.88 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers12 claims12 services$61.34 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 3

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

ARUN JACOB MD
Internal Medicine
1213 E TRINITY MILLS RD STE 173
CARROLLTON, TX 75006
Dallas County (972) 962-1296
PENINNAH MAINA
Nurse Practitioner (Family)
1213 E TRINITY MILLS RD STE 173
CARROLLTON, TX 75006
Dallas County (972) 962-1296
DR. ANITA DHIRUBHAI PATEL D.O
Internal Medicine
1213 E TRINITY MILLS RD STE 173
CARROLLTON, TX 75006
Dallas County (972) 962-1296

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 Roy Setzenfand's NPI number?

The NPI number for Roy Setzenfand is 1659305696. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Roy Setzenfand located?

Roy Setzenfand practices at 1213 E Trinity Mills Rd Ste 173, Carrollton, TX 75006. The listed phone number is (972) 962-1296.

What is Roy Setzenfand's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Roy Setzenfand enrolled in Medicare?

Yes. Roy Setzenfand 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.

Which organization bills Medicare for Roy Setzenfand's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roy Setzenfand reassigns Medicare benefits to Oak Street Health Of Texas, PLLC (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roy Setzenfand's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roy Setzenfand was last updated on May 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.