Active NPI 1831170166 Individual Practitioner Male Practitioner

Dr. Richard Edward Caplan , MD

Surgery • Houston, TX

Professional Overview & Biography Verified Profile Summary

Dr. Richard Caplan, MD is a registered healthcare professional specializing in Surgery in Houston, TX. Practice services are available at 6550 FANNIN ST under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, repair of groin hernia (5 years or older). Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6550 Fannin St
Suite 1601

Houston, TX 770302717

Telephone 7134415141

Fax 7137906470

Associated Practice Facility / Clinic

🏢 Colon & Rectal Clinic, P. A. Facility NPI 1245223262

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Houston, TX

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 20.3 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

376 Specialists

Practicing in Houston, TX (2342 Statewide)

Telehealth Adoption Rate

12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

72.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

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
99213 Established patient office or other outpatient visit, typically 15 minutes	51	42	$212.00	$91.42
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$483.00	$165.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	25	$314.00	$125.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	25	$128.00	$56.86
49505 Repair of groin hernia (5 years or older)	18	18	$2642.42	$563.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$317.00	$112.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$483.00	$169.40
99213 Established patient office or other outpatient visit, typically 15 minutes	51	46	$212.00	$90.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	40	$314.00	$129.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	29	$128.00	$57.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$317.00	$114.18
49505 Repair of groin hernia (5 years or older)	27	27	$2618.61	$553.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	74	74	$317.00	$114.95
99213 Established patient office or other outpatient visit, typically 15 minutes	68	60	$212.00	$92.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$483.00	$171.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	27	$314.00	$131.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	25	$128.00	$58.36
49505 Repair of groin hernia (5 years or older)	21	21	$2693.43	$571.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	76	76	$317.00	$116.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	68	68	$483.00	$172.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	35	33	$314.00	$132.60
99213 Established patient office or other outpatient visit, typically 15 minutes	30	27	$212.00	$92.40
49505 Repair of groin hernia (5 years or older)	28	28	$2662.82	$541.12
99231 Follow-up hospital inpatient care per day, typically 15 minutes	28	14	$115.00	$39.35
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	15	$401.00	$139.36
19301 Partial removal of breast	15	15	$3192.00	$689.96
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$128.00	$58.37
47562 Removal of gallbladder using an endoscope	12	12	$3707.00	$655.73
49507 Repair of trapped groin hernia patient age 5 years or older	11	11	$2946.00	$573.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	72	33	$115.00	$39.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	62	62	$483.00	$169.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	37	28	$401.00	$138.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$317.00	$110.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	26	$314.00	$112.07
49505 Repair of groin hernia (5 years or older)	24	24	$2624.56	$562.28
99213 Established patient office or other outpatient visit, typically 15 minutes	23	19	$212.00	$77.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	17	$128.00	$45.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$483.00	$164.68
99213 Established patient office or other outpatient visit, typically 15 minutes	37	33	$212.00	$73.67
99231 Follow-up hospital inpatient care per day, typically 15 minutes	33	14	$115.00	$39.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	32	31	$314.00	$110.21
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	13	$401.00	$138.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$317.00	$109.65
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	16	$128.00	$45.69
49505 Repair of groin hernia (5 years or older)	17	17	$2571.00	$522.23
47562 Removal of gallbladder using an endoscope	11	11	$3707.00	$649.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	75	75	$483.00	$165.69
99231 Follow-up hospital inpatient care per day, typically 15 minutes	67	34	$115.00	$39.59
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	42	40	$401.00	$136.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	29	$314.00	$109.34
99213 Established patient office or other outpatient visit, typically 15 minutes	23	21	$212.00	$73.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	19	$128.00	$44.51
49505 Repair of groin hernia (5 years or older)	14	13	$2662.82	$536.12
47562 Removal of gallbladder using an endoscope	12	12	$3707.00	$622.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	92	92	$483.00	$161.45
99231 Follow-up hospital inpatient care per day, typically 15 minutes	75	38	$115.00	$39.71
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	48	42	$401.00	$135.28
99213 Established patient office or other outpatient visit, typically 15 minutes	25	22	$212.00	$72.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	22	$314.00	$108.63
47562 Removal of gallbladder using an endoscope	19	19	$3707.00	$629.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	17	$128.00	$44.06
49505 Repair of groin hernia (5 years or older)	18	18	$2642.42	$549.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$317.00	$108.90

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX F6505

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Specialist

NUCC Taxonomy Code: 174400000X

State License TX F6505

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

043709704 (TX)

Medicaid State Provider ID

043709703 (TX)

Commercial Insurance / Payer ID Bcbs

8EV166 (TX)

Commercial Insurance / Payer ID Medicare Railroad

P00022224 (TX)

Commercial Insurance / Payer ID Bcbs

8GD686 (TX)

Practice Associates & Co-Workers

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

38 Associated Practitioners

Dr. Sherilyn Gordon Burroughs , MD

Transplant Surgery

NPI 1003841990

Doctor of Medicine (M.D.)

Dr. Nestor Esnaola , MD

Surgery - Surgical Oncology

NPI 1013021666

Doctor of Medicine (M.D.)

Lisa Degarmo , NP

Nurse Practitioner - Acute Care

NPI 1063727485

Nurse Practitioner

Dr. Ahmed Gaber , MD

Transplant Surgery

NPI 1073579835

Doctor of Medicine (M.D.)

Dr. Lee Morris , MD

Surgery - Vascular Surgery

NPI 1134300387

Doctor of Medicine (M.D.)

Dr. Jasleen Randhawa , MD

Internal Medicine - Hematology & Oncology

NPI 1134305675

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events

✅

NPI Profile Active January 17, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location January 17, 2017

Registered at 6550 FANNIN ST, SUITE 1601, HOUSTON, TX 770302717 (Tel: 7134415141)

📍

Updated Business Mailing Address January 17, 2017

Registered at 6550 FANNIN ST, SUITE 1601, HOUSTON, TX 770302717 (Tel: 7134415141)

👤

Provider Name / Credentials Updated January 17, 2017

Recorded as RICHARD CAPLAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 17, 2017

Specialist (License #F6505 in TX)

✅

NPI Profile Active March 05, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location March 05, 2008

Registered at 6560 FANNIN ST, SUITE 1008, HOUSTON, TX 770302761 (Tel: 7137958585)

📍

Updated Business Mailing Address March 05, 2008

Registered at 6560 FANNIN ST, SUITE 1008, HOUSTON, TX 770302761 (Tel: 7137958585)

👤

Provider Name / Credentials Updated March 05, 2008

Recorded as RICHARD CAPLAN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2008

Specialist (License #F6505 in TX)

🟢

Initial NPI Registration & Enumeration November 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1831170166

Entity Type:

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

Enumeration Date: November 14, 2005

Last Update: January 17, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6550 Fannin St, Suite 1601

Houston, TX 770302717

Phone: 7134415141

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.