AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA — NPI 1699765107 (Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) in TYLER, TX)

CMS-1500 Box 24J / 33a • NPI

1699765107

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207X00000X (CMS 02)

Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)

Box 32 Service Location & ZIP+4

3414 GOLDEN ROAD, TYLER, TX, 75701

Official NPPES Practice Location

Practice Phone & Referral Fax

(903) 939-7500

Fax: (903) 939-7728

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1699765107 (AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1699765107` (NPI-2 Organization / Facility)
Provider / Legal Name	AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA
Plain-English Specialty	Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) NUCC Code: `207X00000X` (Orthopaedic Surgery)
Certifying / Licensing Body	American Board of Orthopaedic Surgery (ABOS)
Practice Location Address	3414 GOLDEN ROAD, TYLER, TX, 75701
Practice Telephone / Fax	Tel: (903) 939-7500 \| Fax: (903) 939-7728
Administrative Mailing Address	PO BOX 610307, DALLAS, TX, 75261-0307
Enumeration & Last Sync	Enumerated: 2005-10-26 \| CMS Record Updated: 2019-01-28
Authorized Official	HEIDI EBERT (Billing Supervisor)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3414 GOLDEN ROAD, TYLER, TX, 75701

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Plain-English Taxonomy & CMS Crosswalk (207X00000X)

What Does Taxonomy Code 207X00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207X00000X translates to:
"Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 20 (Physician/Orthopedic Surgery)
Certifying / Accrediting Authority: American Board of Orthopaedic Surgery (ABOS)
Clinical Scope: Severe knee or hip arthritis, bone fractures, torn ligaments or meniscus, rotator cuff shoulder pain, or persistent back and sciatica pain.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA)

Typical CPT / Diagnostic Procedures:

Total Knee Arthroplasty (CPT 27447) & Total Hip Arthroplasty (CPT 27130)
Arthroscopic Rotator Cuff & ACL Ligament Reconstruction
Intra-Articular Corticosteroid & Hyaluronic Acid Joint Injections (CPT 20610)
Fracture Reduction, Internal Fixation & Carpal Tunnel Release

Common Therapeutic Classes:

NSAIDs & Selective COX-2 Inhibitors (Meloxicam, Celecoxib, Naproxen)
Intra-Articular Triamcinolone Acetonide & Methylprednisolone
Postoperative Venous Thromboembolism (VTE) Prophylaxis (Apixaban, Rivaroxaban)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`332B00000X` — Durable Medical Equipment & Medical Supplies Plain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies	State: TX \| License: `0863040001` \| Primary: Secondary
`207X00000X` — Orthopaedic Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA (NPI #1699765107)