Active NPI 1659305696 Individual Practitioner Male Practitioner

Dr. Roy A Setzenfand , MD

Internal Medicine • Carrollton, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Roy Setzenfand, MD is a certified Internal Medicine practicing in Carrollton, TX. With approximately 32 years of clinical experience since graduating from Hahnemann University College Of Medicine in 1994, Dr. Setzenfand delivers high-quality medical care to the local community at 1213 E TRINITY MILLS RD STE 173.

Dr. Setzenfand maintains professional affiliations with Legacy Healthcare Services Inc, Oak Street Health Of Texas Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1213 E Trinity Mills Rd Ste 173

Carrollton, TX 750061446

Telephone 9729621296

Fax 4693404129

Associated Practice Facility / Clinic

🏢 Oak Street Health Of Texas, Pllc Facility NPI 1497387419

Medicare Profile & Education

Medical School

Hahnemann University College Of Medicine

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Carrollton, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +3.0 yrs vs City Avg

City Avg: 29.0 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

28 Specialists

Practicing in Carrollton, TX (9538 Statewide)

Telehealth Adoption Rate

39.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Setzenfand (32 Years) 32 Yrs

Carrollton Specialty Average (29.0 Years) 29.0 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
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	51	$104.25	$56.01
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	18	18	$246.39	$128.14
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$137.04	$71.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	138	64	$103.58	$56.61
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	11	11	$567.00	$280.25
G0009 Administration of pneumococcal vaccine	11	11	$55.66	$30.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	146	79	$105.98	$56.85
36415 Insertion of needle into vein for collection of blood sample	59	58	$5.01	$3.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	59	$190.67	$125.44
99213 Established patient office or other outpatient visit, typically 15 minutes	40	34	$133.93	$88.65
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	26	26	$197.27	$128.40
G0008 Administration of influenza virus vaccine	21	21	$31.03	$29.45
90662 Influenza vaccine split virus, preservative free	18	18	$130.52	$68.54
G0009 Administration of pneumococcal vaccine	17	17	$31.66	$29.92
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	15	15	$529.47	$278.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	351	199	$186.92	$124.75
36415 Insertion of needle into vein for collection of blood sample	235	170	$5.01	$3.00
99213 Established patient office or other outpatient visit, typically 15 minutes	177	111	$130.88	$88.33
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	83	81	$44.00	$29.55
G0008 Administration of influenza virus vaccine	81	79	$25.00	$16.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	61	61	$191.49	$128.96
93000 Routine ekg using at least 12 leads including interpretation and report	30	29	$22.50	$14.34
87804 Detection test by immunoassay with direct visual observation for influenza virus	17	12	$25.00	$16.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$245.14	$163.39
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	13	$25.00	$16.53
81003 Automated urinalysis test	11	11	$4.00	$2.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	277	171	$160.55	$105.74
36415 Insertion of needle into vein for collection of blood sample	198	132	$6.07	$3.00
93000 Routine ekg using at least 12 leads including interpretation and report	69	69	$27.75	$16.48
99213 Established patient office or other outpatient visit, typically 15 minutes	56	45	$110.70	$72.26
G0008 Administration of influenza virus vaccine	51	51	$25.00	$16.22
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	49	49	$44.00	$29.23
G0444 Annual depression screening, 5 to 15 minutes	37	37	$27.32	$17.61
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	31	31	$170.17	$112.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$242.00	$160.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$158.00	$104.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	474	219	$169.00	$105.15
36415 Insertion of needle into vein for collection of blood sample	353	197	$20.00	$2.93
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	137	137	$165.00	$111.92
G0444 Annual depression screening, 5 to 15 minutes	137	137	$30.00	$17.31
G0008 Administration of influenza virus vaccine	130	129	$40.00	$15.90
90756 Vaccine for influenza for injection into muscle	130	129	$52.00	$26.04
93000 Routine ekg using at least 12 leads including interpretation and report	106	103	$63.00	$16.33
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	81	81	$52.00	$17.69
99213 Established patient office or other outpatient visit, typically 15 minutes	70	54	$123.00	$71.70
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	55	39	$251.00	$140.86
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	11	$158.00	$51.33
81003 Automated urinalysis test	11	11	$18.00	$2.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	606	241	$169.00	$103.83
36415 Insertion of needle into vein for collection of blood sample	472	233	$20.00	$2.93
90756 Vaccine for influenza for injection into muscle	153	151	$52.00	$22.04
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	152	152	$165.00	$112.32
G0008 Administration of influenza virus vaccine	150	148	$40.00	$19.51
G0444 Annual depression screening, 5 to 15 minutes	150	150	$30.00	$17.22
93000 Routine ekg using at least 12 leads including interpretation and report	131	127	$63.00	$16.28
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	100	100	$52.00	$19.25
99354 Prolonged office or other outpatient service first hour	82	59	$255.00	$126.96
99213 Established patient office or other outpatient visit, typically 15 minutes	35	31	$123.00	$70.41
81003 Automated urinalysis test	17	14	$18.00	$2.71
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	$158.00	$51.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	612	253	$169.00	$102.72
36415 Insertion of needle into vein for collection of blood sample	533	250	$20.00	$2.91
G0008 Administration of influenza virus vaccine	177	175	$40.00	$23.91
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	155	155	$50.00	$23.56
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	130	130	$165.00	$110.49
G0444 Annual depression screening, 5 to 15 minutes	129	129	$30.00	$17.07
93000 Routine ekg using at least 12 leads including interpretation and report	104	102	$63.00	$16.14
99213 Established patient office or other outpatient visit, typically 15 minutes	99	75	$123.00	$69.98
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	99	99	$52.00	$21.38
99354 Prolonged office or other outpatient service first hour	90	64	$255.00	$125.35
G0009 Administration of pneumococcal vaccine	51	50	$37.00	$23.91
90670 Pneumococcal vaccine for injection into muscle	47	46	$210.00	$184.68
G0179 Physician re-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 to affirm the initial imp	32	13	$132.00	$39.41
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	15	14	$158.00	$51.34
81003 Automated urinalysis test	13	13	$18.00	$3.02

Medical Specialties & State Licenses

CMS Verified: 2022-05-17

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License TX L8947

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.

Hospital & Practice Group Affiliations

Oak Street Health Of Texas Pllc

3401 Alta Mere Dr, Fort Worth, TX 761167111

Phone: 8172104229

Oak Street Health Of Texas Pllc

4115 E Lancaster Ave, Fort Worth, TX 761033614

Phone: 8177967370

Legacy Healthcare Services Inc

800 College Pkwy, Lewisville, TX 750773503

Phone: 9724208543

Oak Street Health Of Texas Pllc

2740 Valwood Pkwy, Dallas, TX 752343562

Phone: 4695183200

Secondary Practice Locations

4510 Medical Center Dr, Suite 311

Mckinney, TX 750691650

Phone: 9725406256

1515 S Buckner Blvd Ste 141

Dallas, TX 752171794

Phone: 2143057065

8840 Benbrook Blvd Ste 101

Benbrook, TX 761262173

Phone: 8178137101

4801 S Cooper St Ste 401

Arlington, TX 760175963

Phone: 8178137100

1950 Ephriham Ave

Fort Worth, TX 761646670

Phone: 8178137075

2110 N Galloway Ave Ste 116

Mesquite, TX 751505737

Phone: 9724265426

4115 E Lancaster Ave

Fort Worth, TX 761033614

Phone: 8177967370

2928 N Belt Line Rd

Irving, TX 750625247

Phone: 2143077786

2360 Gus Thomasson Rd

Dallas, TX 752283005

Phone: 2143017071

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Arun Jacob , MD

Internal Medicine

NPI 1053688457

Doctor of Medicine (M.D.)

Peninnah Maina

Nurse Practitioner - Family

NPI 1205466109

Dr. Anita Patel , DO

Internal Medicine

NPI 1265643852

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location May 17, 2022

Registered at 1213 E TRINITY MILLS RD STE 173, CARROLLTON, TX 750061446 (Tel: 9729621296)

📍

Updated Business Mailing Address May 17, 2022

Registered at PO BOX 746079, ATLANTA, GA 303746079 (Tel: 3127339730)

✅

NPI Profile Active May 01, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location May 01, 2008

Registered at 4510 MEDICAL CENTER DR, SUITE 311, MCKINNEY, TX 750691650 (Tel: 9725406256)

📍

Updated Business Mailing Address May 01, 2008

Registered at 4510 MEDICAL CENTER DR, SUITE 311, MCKINNEY, TX 750691650 (Tel: 9725406256)

👤

Provider Name / Credentials Updated May 01, 2008

Recorded as ROY SETZENFAND, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2008

Internal Medicine (License #L8947 in TX)

🟢

Initial NPI Registration & Enumeration July 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659305696

Entity Type:

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

Enumeration Date: July 10, 2006

Last Update: May 17, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 746079

Atlanta, GA 303746079

Phone: 3127339730

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

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.