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SOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC
NPI 1871099739
Orthopaedic Surgery in Fort Worth, TX

Active since March 31, 2018
800 12TH AVE STE 200, FORT WORTH, TX 76104(214) 631-9881(972) 438-2077 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 6, 2026, Sep 19, 2025, Feb 7, 2020 and 2 more (5 updates tracked since 2018).

About Southlake Orthopedics & Sports Medicine, Pllc NPPES

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

SOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC (NPI 1871099739), doing business as Summit Orthopedics Of Texas, is a healthcare organization registered as an orthopaedic surgery in Fort Worth, Texas and active in the NPI registry since March 2018. The organization maintains a secondary practice location in Keller and lists Bantoo Sehgal, Owner, as its authorized official.

NPPES Registry Identity

NPI1871099739
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameSOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC
Location Address800 12TH AVE STE 200Fort Worth, TX 76104-2519
Mailing Address800 12th Ave Ste 200Fort Worth, TX 76104-2519 · (214) 631-9881 · Fax (469) 482-2526
Phone(214) 631-9881
Fax(972) 438-2077
Organization SubpartNo
Authorized OfficialBantoo SehgalOwner · (214) 631-9881
Enumeration DateMarch 31, 2018
Last NPPES UpdateMay 6, 20265 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1871099739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in TX · R0125
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.
800 12TH AVE STE 200, Fort Worth, TX 76104
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Other Names 1

Doing Business AsSummit Orthopedics Of Texas

Secondary Practice Location 1

Location 11149 Keller Pkwy Ste AKeller, TX 76248-1620 · Phone (214) 631-9881 · Fax (469) 482-2526

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southlake Orthopedics & Sports Medicine, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southlake Orthopedics & Sports Medicine, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Bantoo Sehgal, M.D.
Orthopedic Surgery
NPI 1558677690
800 12TH AVE STE 200
Fort Worth, TX 76104
(214) 631-9881
✔ PECOS✔ Accepts MedicareSame address

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

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 Southlake Orthopedics & Sports Medicine, PLLC's NPI number?

The NPI number for Southlake Orthopedics & Sports Medicine, PLLC is 1871099739. It was assigned to this organization in the NPPES registry on March 31, 2018. The provider is doing business as Summit Orthopedics of Texas.

Where is Southlake Orthopedics & Sports Medicine, PLLC located?

Southlake Orthopedics & Sports Medicine, PLLC is located at 800 12th Ave Ste 200, Fort Worth, TX 76104. The listed phone number is (214) 631-9881.

What is Southlake Orthopedics & Sports Medicine, PLLC's specialty?

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

Is Southlake Orthopedics & Sports Medicine, PLLC enrolled in Medicare?

Yes. Southlake Orthopedics & Sports Medicine, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southlake Orthopedics & Sports Medicine, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Southlake Orthopedics & Sports Medicine, PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southlake Orthopedics & Sports Medicine, PLLC accept?

Health plans from Molina Healthcare list Southlake Orthopedics & Sports Medicine, PLLC 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.

When was this NPI record last updated?

The NPPES record for Southlake Orthopedics & Sports Medicine, PLLC was last updated on May 6, 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.