DR. THEODORE ANDREW BELANGER MD
NPI 1700869997
Orthopaedic Surgery in Rockwall, TX

Q: What is Theodore Belanger's NPI number?

The NPI number for Theodore Belanger is 1700869997. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Q: What is Theodore Belanger's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Theodore Belanger was last updated on January 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 November 22, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

3164 HORIZON RD, SUITE 100, ROCKWALL, TX 75032(972) 772-8767(972) 772-8780 Get Directions Write a Review

NPPES record last updated: January 14, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Dr. Theodore Andrew Belanger Md NPPES

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

DR. THEODORE ANDREW BELANGER MD (NPI 1700869997) is an individual orthopaedic surgery provider in Rockwall, Texas, licensed in North Carolina (2003-00556) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Hunt Regional Medical Center, and is a graduate of University Of Wisconsin School Of Medicine (1997).

NPPES Registry Identity

NPI1700869997

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. THEODORE ANDREW BELANGERCredential: MD

Location Address3164 HORIZON RD, SUITE 100Rockwall, TX 75032-7805

Mailing AddressPo Box 262409Plano, TX 75026-2409 · (972) 772-8767 · Fax (972) 473-3929

Phone(972) 772-8767

Fax(972) 772-8780

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1997

Enumeration DateNovember 22, 2005

Last NPPES UpdateJanuary 14, 2016

✔ NPI 1700869997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NC · 2003-00556

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.

Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 2006-00556 (NC)

3164 HORIZON RD, Rockwall, TX 75032

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Other Identifiers 4

Medicaid89134HWNC

Medicare UPINH76380NC

Medicare PIN2028198BNC

Medicare NSC0397730004

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. Theodore Andrew Belanger 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 ID6709860174

PECOS Enrollment IDI20110328000845

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 20

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.

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

264 services168 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.

184 services120 patients

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.

92 services70 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.

87 services87 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.

80 services64 patients

Fusion of additional segment of spine 22614

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

67 services25 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

61 services36 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment 63048

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

49 services27 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.

37 services37 patients

Fusion of spine in lower back 22612

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

33 services33 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

31 services21 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

29 services29 patients

X-ray of middle spine, 2 views 72070

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

27 services23 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

26 services26 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

23 services23 patients

Fusion of lower spine bone through abdomen with partial removal of disc 22558

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

21 services21 patients

X-ray of entire middle and lower spine, 2-3 views 72082

An X-ray of your middle and lower spine involves capturing images of these areas to identify any abnormalities. The procedure involves taking 2-3 different views for a comprehensive understanding. It's non-invasive and usually painless, helping doctors diagnose conditions like fractures or infections.

19 services16 patients

Placement of stabilizing device to back of 1 spine bone in neck 22840

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

18 services18 patients

Treatment of broken lower spine bone with placement of stabilizing device 22514

This procedure involves fixing a broken bone in the lower spine. A stabilizing device is inserted to support the bone, promoting healing and reducing pain. The device helps to maintain proper spinal alignment and stability during your recovery period.

15 services14 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

14 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Hunt Regional Medical Center

Acute Care Hospitals · Greenville, TX

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450352

Location4215 Joe Ramsey Blvd EGreenville, TX 75401 · Hunt County

Emergency services Birthing friendly

Medical City Plano

Acute Care Hospitals · Plano, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450651

Location3901 W 15th StPlano, TX 75075 · Collin County

Emergency services Birthing friendly

Christus St Michael Health System

Acute Care Hospitals · Texarkana, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450801

Location2600 St Michael DrTexarkana, TX 75503 · Bowie County

Emergency services Birthing friendly

Texas Health Center For Diagnostics & Surgery

Acute Care Hospitals · Plano, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450891

Location6020 W Parker RoadPlano, TX 75093 · Collin County

Emergency services

Texas Health Presbyterian Hospital Rockwall

Acute Care Hospitals · Rockwall, TX

5/5 CMS rating

OwnershipProprietary

CMS Certification Number670044

Location3150 Horizon RoadRockwall, TX 75032 · Rockwall County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75032 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

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

75/100

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

Scored as part of a group practice

Reported Quality Measures

Clinical Information Reconciliation

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.

96%1,733 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%1,733 patients4/55-star benchmark: 100%

Documentation of Signed Opioid Treatment Agreement

All patients 18 and older prescribed opiates for longer than six weeks duration who signed an opioid treatment agreement at least once during Opioid Therapy documented in the medical record

76%249 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.

11%246 patients1/55-star benchmark: 100%

Functional Outcome Assessment

Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified…

99%1,795 patients4/55-star benchmark: 100%

Pain Assessment and Follow-Up

Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present

96%1,795 patients4/55-star benchmark: 100%

Patient-Generated Health Data

Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.

0%1,008 patients

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

97%959 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

58%934 patients3/55-star benchmark: 95%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

97%959 patients4/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

91%128 patients4/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

24%1,008 patients1/55-star benchmark: 100%

Request/Accept Summary of Care

0%676 patients1/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…

18%1,008 patients1/55-star benchmark: 75%

View, Download and Transmit (VDT)

During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.

8%1,008 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.

KEVIN L JU M.D.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

3164 HORIZON RD, SUITE 100
ROCKWALL, TX 75032

Rockwall County (972) 772-8780

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 Theodore Belanger's NPI number?

The NPI number for Theodore Belanger is 1700869997. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Where is Theodore Belanger located?

Theodore Belanger practices at 3164 Horizon Rd Suite 100, Rockwall, TX 75032. The listed phone number is (972) 772-8767.

What is Theodore Belanger's specialty?

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

Is Theodore Belanger enrolled in Medicare?

Yes. Theodore Belanger 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 Theodore Belanger accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Theodore Belanger 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 Theodore Belanger affiliated with any hospitals?

According to CMS data, Theodore Belanger is affiliated with Hunt Regional Medical Center, Medical City Plano, Christus St Michael Health System, Texas Health Center For Diagnostics & Surgery and Texas Health Presbyterian Hospital Rockwall.

When was this NPI record last updated?

The NPPES record for Theodore Belanger was last updated on January 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.