Active NPI 1518941475 Individual Practitioner Male Practitioner

Dr. Douglas G Cummins , MD

Surgery • Lubbock, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Cummins, MD is a certified Surgery practicing in Lubbock, TX. With approximately 27 years of clinical experience since completing medical education in 1999, Dr. Cummins delivers high-quality medical care to the local community at 4515 MARSHA SHARP FWY.

Dr. Cummins is affiliated with Covenant Medical Group and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, removal of polyps or growths of large bowel using an endoscope with mechanical snare, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4515 Marsha Sharp Fwy

Lubbock, TX 794072520

Telephone 8067447223

Fax 8067403325

Associated Practice Facility / Clinic

🏢 Grace Clinic Of Lubbock Facility NPI 1912953357

Medicare Profile & Education

Medical School

Other

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Lubbock, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +0.9 yrs vs City Avg

City Avg: 26.1 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

40 Specialists

Practicing in Lubbock, TX (2342 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

78.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Cummins (27 Years) 27 Yrs

Lubbock Specialty Average (26.1 Years) 26.1 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
99213 Established patient office or other outpatient visit, typically 15 minutes	97	68	$125.00	$86.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	61	$177.00	$115.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	63	45	$79.00	$53.65
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	29	29	$1493.00	$233.26
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	26	26	$966.00	$74.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$285.00	$154.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$202.00	$106.55
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	12	$405.00	$124.70
45380 Biopsy of large bowel using an endoscope	13	13	$1316.00	$78.49
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	12	12	$600.00	$164.64

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	86	69	$172.23	$120.38
99213 Established patient office or other outpatient visit, typically 15 minutes	82	63	$112.02	$85.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	40	$79.00	$54.05
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	32	31	$966.00	$60.51
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$285.00	$159.45
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	16	16	$1493.00	$232.96
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$389.47	$124.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$202.00	$107.33
45380 Biopsy of large bowel using an endoscope	12	12	$1316.00	$158.96
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$1154.00	$150.66

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	55	44	$172.00	$120.37
99213 Established patient office or other outpatient visit, typically 15 minutes	46	37	$111.00	$85.92
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	30	29	$966.00	$77.06
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	26	$79.00	$54.40
99231 Follow-up hospital inpatient care per day, typically 15 minutes	26	16	$70.00	$36.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$285.00	$161.38
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	19	19	$405.00	$129.20
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	19	19	$1493.00	$243.23
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	12	12	$1154.00	$176.97

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	50	44	$172.00	$126.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$285.00	$163.39
99213 Established patient office or other outpatient visit, typically 15 minutes	41	34	$111.00	$89.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	38	31	$79.00	$54.77
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	27	26	$966.00	$73.10
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	19	19	$1493.00	$218.45
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	17	17	$1154.00	$164.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	11	$250.00	$176.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$202.00	$109.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	65	56	$111.98	$73.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	41	$172.00	$107.42
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	37	36	$966.00	$82.32
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$285.00	$160.11
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	30	27	$249.93	$142.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	27	20	$78.85	$44.46
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	17	17	$1154.00	$187.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$202.00	$105.52
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$361.00	$205.40
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	12	12	$1417.17	$257.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	69	55	$121.86	$71.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	48	$181.00	$103.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$177.11	$103.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$274.59	$160.01
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	30	29	$434.21	$86.59
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	30	29	$629.07	$257.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	19	$74.46	$43.54
45380 Biopsy of large bowel using an endoscope	14	14	$691.87	$149.44
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	13	12	$3460.29	$1531.85
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$349.08	$201.20

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	63	57	$204.62	$108.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	53	$85.00	$44.05
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	55	55	$350.00	$209.33
99213 Established patient office or other outpatient visit, typically 15 minutes	53	40	$149.09	$73.67
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	35	34	$516.53	$96.85
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	24	24	$933.28	$248.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	17	$333.45	$139.47
43281 Repair of hernia of muscle at esophagus and stomach using an endoscope	15	15	$4522.73	$1582.57
45380 Biopsy of large bowel using an endoscope	14	14	$787.55	$113.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$192.39	$106.99
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$445.12	$91.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$306.17	$165.24
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	11	11	$648.00	$197.05

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	102	76	$76.27	$41.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	69	$161.22	$102.84
99213 Established patient office or other outpatient visit, typically 15 minutes	66	51	$105.30	$69.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$257.24	$157.30
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	41	39	$512.00	$79.81
45378 Diagnostic exam of large bowel using a flexible endoscope	28	28	$648.00	$173.14
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	26	26	$923.00	$249.39
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	23	22	$433.00	$87.92
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	15	15	$300.00	$188.70
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$340.00	$132.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$201.43	$103.23
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	12	12	$648.00	$176.25

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX K7706

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

030789403 (TX)

Commercial Insurance / Payer ID Bcbs

8BE420 (TX)

Commercial Insurance / Payer ID Medicare Railroad

P00214637 (TX)

Hospital & Practice Group Affiliations

Covenant Medical Group

9812 Slide Rd, Lubbock, TX 794245781

Phone: 8067258400

Covenant Medical Group

2215 Nashville Ave, Lubbock, TX 794101105

Phone: 8067255844

Covenant Medical Group

2502 Xenia St, Plainview, TX 790721818

Phone: 8062967881

Covenant Medical Group

2601 Dimmitt Rd, Plainview, TX 790721833

Phone: 8062965531

Covenant Medical Group

2504 Xenia St, Plainview, TX 790721818

Phone: 8062915145

Covenant Medical Group

2508 Xenia St, Plainview, TX 790721818

Phone: 8062915145

Secondary Practice Locations

2512 Xenia St, Suite 105

Plainview, TX 790721818

Phone: 8062969300

Practice Associates & Co-Workers

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

40 Associated Practitioners

Kayleigh Minielly , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003370909

Certified Registered Nurse Anesthetist

Brooklyn Fleming , MSN, NP

Nurse Practitioner - Acute Care

NPI 1003533910

Master of Science in Nursing, Nurse Practitioner

Liesl Olson , PT

Physical Therapist

NPI 1003846866

Physical Therapist

Sixtus Atabong , PA

Physician Assistant - Surgical

NPI 1013987155

Physician Assistant

Dr. Benjamin Fluhman , DPM

Podiatrist - Foot & Ankle Surgery

NPI 1023325024

Doctor of Podiatric Medicine

Dr. Howard Hurd , MD

Internal Medicine - Cardiovascular Disease

NPI 1033112560

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

7 Historical Events

📍

Updated Practice Location November 30, 2018

Registered at 4515 MARSHA SHARP FWY, LUBBOCK, TX 794072520 (Tel: 8067447223)

✅

NPI Profile Active September 02, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location September 02, 2011

Registered at 2512 XENIA ST, SUITE 105, PLAINVIEW, TX 790721818 (Tel: 8062969300)

📍

Updated Business Mailing Address September 02, 2011

Registered at 2512 XENIA ST, SUITE 105, PLAINVIEW, TX 790721818 (Tel: 8062969300)

👤

Provider Name / Credentials Updated September 02, 2011

Recorded as DOUGLAS CUMMINS, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2011

Surgery (License #K7706 in TX)

🟢

Initial NPI Registration & Enumeration December 05, 2005

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: 1518941475

Entity Type:

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

Enumeration Date: December 05, 2005

Last Update: November 30, 2018

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

2512 Xenia St, Suite 105

Plainview, TX 790721818

Phone: 8062969300

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.