Active NPI 1215948963 Individual Practitioner Male Practitioner

Dr. Thomas Michael Fox , DO

Orthopaedic Surgery • Niceville, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Fox, DO is a certified Orthopaedic Surgery practicing in Niceville, FL. With approximately 42 years of clinical experience since graduating from Philadelphia College Of Osteopathic Medicine in 1984, Dr. Fox delivers high-quality medical care to the local community at 1950 BLUEWATER BLVD.

Dr. Fox is affiliated with North Florida Surgeons Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, hyaluronan or derivative, durolane, for intra-articular injection, 1 mg, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1950 Bluewater Blvd
Suite 100

Niceville, FL 325783887

Telephone 8508978081

Fax 8508971520

Associated Practice Facility / Clinic

🏢 Orthopedic & Sports Physical Therapy Center Llc Facility NPI 1881632008

Medicare Profile & Education

Medical School

Philadelphia College Of Osteopathic Medicine

Graduation Year

1984

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Niceville, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

42 Yrs +7.2 yrs vs City Avg

City Avg: 34.8 Yrs

State Avg: 27.1 Yrs

Regional Practice Density

4 Specialists

Practicing in Niceville, FL (1597 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

69.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fox (42 Years) 42 Yrs

Niceville Specialty Average (34.8 Years) 34.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1010 Injection, methylprednisolone acetate, 1 mg	10,303	181	$0.50	$0.13
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	1,680	19	$50.00	$6.48
20610 Aspiration and/or injection of fluid from large joint	304	220	$235.29	$69.85
99213 Established patient office or other outpatient visit, typically 15 minutes	271	229	$210.00	$91.64
73560 X-ray of knee, 1-2 views	235	223	$108.34	$39.90
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	208	35	$90.00	$22.56
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	185	167	$126.00	$57.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	164	151	$310.00	$130.69
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	132	20	$94.00	$27.68
73030 X-ray of shoulder, minimum of 2 views	111	106	$98.11	$37.36
J1030 Injection, methylprednisolone acetate, 40 mg	108	81	$17.00	$6.34
97530 Therapy procedure using functional activities	107	29	$99.00	$31.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	103	103	$315.00	$114.69
97150 Therapy procedure in a group setting	98	32	$58.00	$13.87
73502 X-ray of hip, 2-3 views	77	74	$127.00	$45.87
27447 Replacement of knee joint, both sides of knee	55	54	$4782.00	$1317.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$483.00	$167.95
97140 Therapy procedure using manual technique, each 15 minutes	41	18	$84.00	$20.12
99202 New patient office or other outpatient visit, typically 20 minutes	39	39	$216.00	$73.94
72100 X-ray of lower and sacral spine, 2-3 views	36	35	$108.00	$39.56
73610 X-ray of ankle, minimum of 3 views	27	21	$102.67	$37.69
20550 Injection into tendon or ligament	24	22	$178.33	$54.32
27130 Replacement of thigh bone and hip joint with prosthesis	20	20	$4477.00	$1368.88
23472 Prosthetic repair of shoulder joint, total shoulder	17	17	$4641.00	$1485.92
73522 X-ray of both hips, 3-4 views	15	15	$148.00	$53.76
20552 Injections of trigger points in 1 or 2 muscles	15	13	$161.00	$53.86
29823 Removal of extensive shoulder joint tissue using an endoscope	13	13	$1933.00	$441.36
20605 Aspiration and/or injection of medium joint or joint capsule	12	12	$186.33	$54.14
73140 X-ray of finger, minimum of 2 views	12	12	$99.00	$41.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	960	13	$27.59	$6.84
J1030 Injection, methylprednisolone acetate, 40 mg	282	193	$14.64	$7.38
99213 Established patient office or other outpatient visit, typically 15 minutes	243	208	$193.43	$86.68
20610 Aspiration and/or injection of fluid from large joint	232	173	$169.73	$64.08
73560 X-ray of knee, 1-2 views	192	164	$78.82	$34.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	123	116	$271.50	$122.30
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	118	107	$113.96	$55.28
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$256.01	$108.90
73030 X-ray of shoulder, minimum of 2 views	89	79	$76.53	$32.97
73502 X-ray of hip, 2-3 views	86	74	$97.91	$44.68
27447 Replacement of knee joint, both sides of knee	86	84	$3061.50	$1297.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$359.62	$164.40
27130 Replacement of thigh bone and hip joint with prosthesis	25	24	$3056.98	$1281.32
72100 X-ray of lower and sacral spine, 2-3 views	22	22	$87.30	$37.08
26055 Incision of tendon covering	20	14	$1088.46	$224.43
23472 Prosthetic repair of shoulder joint, total shoulder	18	18	$3661.05	$1470.96
20550 Injection into tendon or ligament	17	14	$144.60	$50.73
73130 X-ray of hand, minimum of 3 views	17	16	$80.10	$35.47
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$146.00	$70.84
73610 X-ray of ankle, minimum of 3 views	13	12	$84.21	$30.97
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	13	13	$104.84	$50.61
20605 Aspiration and/or injection of medium joint or joint capsule	13	11	$137.18	$56.94
20600 Aspiration and/or injection of fluid from small joint	12	12	$142.55	$43.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	1,260	16	$34.45	$10.04
99213 Established patient office or other outpatient visit, typically 15 minutes	303	233	$182.64	$89.61
20610 Aspiration and/or injection of fluid from large joint	295	208	$143.50	$66.27
73560 X-ray of knee, 1-2 views	221	171	$66.90	$33.34
J1030 Injection, methylprednisolone acetate, 40 mg	193	144	$13.20	$6.03
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	167	83	$13.10	$6.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	134	115	$259.40	$126.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	127	114	$111.52	$56.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	92	92	$225.62	$112.12
73030 X-ray of shoulder, minimum of 2 views	89	77	$66.98	$33.87
73502 X-ray of hip, 2-3 views	83	75	$90.74	$45.83
27447 Replacement of knee joint, both sides of knee	77	76	$2698.02	$1330.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$338.16	$167.16
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	39	39	$104.84	$51.40
27130 Replacement of thigh bone and hip joint with prosthesis	34	33	$2701.98	$1300.19
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	30	26	$2332.00	$1214.79
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$146.00	$72.22
73630 X-ray of foot, minimum of 3 views	17	13	$66.94	$33.90
23472 Prosthetic repair of shoulder joint, total shoulder	16	15	$3037.44	$1497.95
72100 X-ray of lower and sacral spine, 2-3 views	14	14	$77.64	$39.01
29823 Removal of extensive shoulder joint tissue using an endoscope	13	13	$1235.32	$277.74
73610 X-ray of ankle, minimum of 3 views	13	12	$71.54	$36.03
20552 Injections of trigger points in 1 or 2 muscles	13	11	$110.12	$52.21
20550 Injection into tendon or ligament	13	13	$113.78	$53.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	504	346	$179.57	$92.09
20610 Aspiration and/or injection of fluid from large joint	353	230	$141.40	$67.26
J1030 Injection, methylprednisolone acetate, 40 mg	338	223	$13.27	$5.57
73560 X-ray of knee, 1-2 views	220	180	$67.05	$33.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	181	181	$225.18	$112.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	146	116	$110.78	$55.51
73030 X-ray of shoulder, minimum of 2 views	102	89	$66.18	$33.22
73502 X-ray of hip, 2-3 views	95	87	$90.20	$44.47
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	81	62	$2320.54	$1219.00
27447 Replacement of knee joint, both sides of knee	67	65	$2705.74	$1344.93
27130 Replacement of thigh bone and hip joint with prosthesis	46	43	$2705.67	$1366.34
Q4206 Fluid flow or fluid gf, 1 cc	42	18	$4120.00	$2060.00
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	39	37	$104.84	$53.02
20550 Injection into tendon or ligament	26	14	$112.07	$47.54
72100 X-ray of lower and sacral spine, 2-3 views	18	17	$77.02	$39.23
23472 Prosthetic repair of shoulder joint, total shoulder	17	17	$3037.44	$1535.97
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$146.00	$73.83
20605 Aspiration and/or injection of medium joint or joint capsule	14	12	$116.93	$51.32
29823 Removal of extensive shoulder joint tissue using an endoscope	11	11	$1235.32	$174.79
72170 X-ray of pelvis, 1-2 views	11	11	$54.50	$27.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	516	360	$148.82	$74.68
J1030 Injection, methylprednisolone acetate, 40 mg	286	176	$14.10	$5.99
20610 Aspiration and/or injection of fluid from large joint	274	176	$136.21	$66.65
73560 X-ray of knee, 1-2 views	192	159	$63.58	$32.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	148	148	$218.30	$108.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	102	74	$89.98	$45.57
73030 X-ray of shoulder, minimum of 2 views	93	81	$59.54	$31.56
73502 X-ray of hip, 2-3 views	79	72	$84.38	$43.28
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	77	76	$106.65	$53.58
27447 Replacement of knee joint, both sides of knee	70	69	$2870.54	$1438.10
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	62	49	$2100.00	$1160.67
27130 Replacement of thigh bone and hip joint with prosthesis	26	26	$2871.92	$1455.37
72100 X-ray of lower and sacral spine, 2-3 views	22	22	$72.02	$37.57
20550 Injection into tendon or ligament	20	15	$108.84	$45.26
20605 Aspiration and/or injection of medium joint or joint capsule	15	12	$131.10	$49.48
23472 Prosthetic repair of shoulder joint, total shoulder	14	14	$3077.52	$1461.51
72170 X-ray of pelvis, 1-2 views	14	12	$64.98	$28.11
20552 Injections of trigger points in 1 or 2 muscles	12	12	$112.06	$47.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	494	345	$147.47	$73.61
J1030 Injection, methylprednisolone acetate, 40 mg	340	229	$14.00	$6.14
20610 Aspiration and/or injection of fluid from large joint	269	203	$139.94	$63.62
73560 X-ray of knee, 1-2 views	254	198	$62.63	$31.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	197	197	$216.72	$106.99
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	84	80	$106.33	$52.19
73502 X-ray of hip, 2-3 views	81	77	$82.88	$40.49
73030 X-ray of shoulder, minimum of 2 views	77	66	$59.19	$29.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	70	64	$89.98	$44.84
27447 Replacement of knee joint, both sides of knee	67	63	$2870.54	$1375.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	45	$216.57	$108.69
27130 Replacement of thigh bone and hip joint with prosthesis	34	33	$2871.92	$1430.90
20605 Aspiration and/or injection of medium joint or joint capsule	23	21	$103.52	$47.09
26055 Incision of tendon covering	21	15	$1137.98	$227.45
72100 X-ray of lower and sacral spine, 2-3 views	18	17	$72.02	$35.88
20550 Injection into tendon or ligament	18	17	$108.84	$49.72
29823 Removal of extensive shoulder joint tissue using an endoscope	15	15	$1289.12	$346.98
72170 X-ray of pelvis, 1-2 views	11	11	$64.98	$32.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	489	377	$123.01	$71.18
J1030 Injection, methylprednisolone acetate, 40 mg	320	228	$9.36	$6.62
20610 Aspiration and/or injection of fluid from large joint	267	218	$116.80	$64.16
73560 X-ray of knee, 1-2 views	238	192	$49.06	$29.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	207	207	$185.00	$107.35
73502 X-ray of hip, 2-3 views	126	111	$54.25	$39.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	124	110	$74.13	$43.13
73030 X-ray of shoulder, minimum of 2 views	123	97	$49.00	$27.95
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	71	70	$91.00	$53.14
27447 Replacement of knee joint, both sides of knee	57	57	$2407.65	$1412.00
27130 Replacement of thigh bone and hip joint with prosthesis	37	37	$2426.00	$1405.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	35	$179.64	$103.49
29823 Removal of extensive shoulder joint tissue using an endoscope	20	20	$1085.00	$229.85
72100 X-ray of lower and sacral spine, 2-3 views	19	19	$59.00	$34.15
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	16	12	$224.00	$84.25
29827 Repair of shoulder rotator cuff using an endoscope	14	14	$1862.00	$1018.40
64721 Release and/or relocation of hand nerve	13	13	$754.00	$419.68
20550 Injection into tendon or ligament	13	13	$102.00	$51.63
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$237.00	$137.97
23472 Prosthetic repair of shoulder joint, total shoulder	11	11	$2601.00	$1515.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	432	344	$123.14	$71.45
J1030 Injection, methylprednisolone acetate, 40 mg	409	283	$7.00	$5.62
20610 Aspiration and/or injection of fluid from large joint	346	259	$112.74	$62.12
73560 X-ray of knee, 1-2 views	265	199	$49.21	$29.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	226	174	$74.00	$42.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	219	219	$185.00	$107.17
73502 X-ray of hip, 2-3 views	142	119	$54.00	$39.57
73030 X-ray of shoulder, minimum of 2 views	117	96	$49.00	$26.66
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	109	103	$91.00	$52.74
27447 Replacement of knee joint, both sides of knee	66	63	$2425.00	$1383.56
27130 Replacement of thigh bone and hip joint with prosthesis	51	48	$2426.00	$1288.45
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	27	15	$224.00	$85.13
20550 Injection into tendon or ligament	19	19	$104.68	$50.32
20552 Injections of trigger points in 1 or 2 muscles	18	16	$94.00	$53.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$183.00	$102.41
73140 X-ray of finger, minimum of 2 views	16	13	$52.00	$30.54
29823 Removal of extensive shoulder joint tissue using an endoscope	16	16	$1085.00	$257.03
20605 Aspiration and/or injection of medium joint or joint capsule	15	14	$86.00	$50.46
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$282.00	$163.47
23472 Prosthetic repair of shoulder joint, total shoulder	15	15	$2601.00	$1477.53
73100 X-ray of wrist, 2 views	14	11	$49.00	$28.20
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$237.00	$137.58
72170 X-ray of pelvis, 1-2 views	13	13	$46.00	$30.96
64721 Release and/or relocation of hand nerve	13	12	$754.00	$363.49
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$127.00	$73.97
29827 Repair of shoulder rotator cuff using an endoscope	12	12	$1862.00	$959.88
73070 X-ray of elbow, 2 views	11	11	$46.00	$26.50

Medical Specialties & State Licenses

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License FL OS6530

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

371732100 (FL)

Hospital & Practice Group Affiliations

North Florida Surgeons Pa

1950 Bluewater Blvd, Niceville, FL 325783888

Phone: 8508978081

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners

Rustin Sorensen , PA-C

Physician Assistant - Surgical

NPI 1164433827

Physician Assistant (Certified)

Erin Robinson , PA-C

Physician Assistant - Surgical

NPI 1346205291

Physician Assistant (Certified)

Russell White , PA

Physician Assistant - Surgical

NPI 1508306473

Physician Assistant

Dr. Bradley Goeke , MD

Orthopaedic Surgery

NPI 1659464196

Doctor of Medicine (M.D.)

Dr. William Markowski , MD

Orthopaedic Surgery

NPI 1831100387

Doctor of Medicine (M.D.)

Jason Belanger

Physical Therapist

NPI 1922818251

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active January 25, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location January 25, 2010

Registered at 1950 BLUEWATER BLVD, SUITE 100, NICEVILLE, FL 325783887 (Tel: 8508978081)

📍

Updated Business Mailing Address January 25, 2010

Registered at 1950 BLUEWATER BLVD, SUITE 100, NICEVILLE, FL 325783887 (Tel: 8508978081)

👤

Provider Name / Credentials Updated January 25, 2010

Recorded as THOMAS FOX, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2010

Orthopaedic Surgery (License #OS6530 in FL)

🟢

Initial NPI Registration & Enumeration August 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1215948963

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 10, 2006

Last Update: January 25, 2010

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1950 Bluewater Blvd, Suite 100

Niceville, FL 325783887

Phone: 8508978081

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

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