Active NPI 1043206774 Individual Practitioner Male Practitioner

Dr. Hugh P Babineau , MD

Surgery • Tyler, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Hugh Babineau, MD is a certified Surgery practicing in Tyler, TX. With approximately 30 years of clinical experience since graduating from University Of Rochester School Of Medicine And Dentistry in 1996, Dr. Babineau delivers high-quality medical care to the local community at 1100 E LAKE ST.

Dr. Babineau is affiliated with Etmc Physician Group, Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include follow-up hospital inpatient care per day, initial hospital inpatient care per day, established 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

1100 E Lake St
Ste 230

Tyler, TX 757013343

Telephone 9035930230

Fax 9035973015

Associated Practice Facility / Clinic

🏢 Mcclintock Obstetrics & Gynecology, P.a. Facility NPI 1497813455

Medicare Profile & Education

Medical School

University Of Rochester School Of Medicine And Dentistry

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Tyler, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

30 Yrs +4.5 yrs vs City Avg

City Avg: 25.5 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

32 Specialists

Practicing in Tyler, TX (2342 Statewide)

Telehealth Adoption Rate

3.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

56.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Babineau (30 Years) 30 Yrs

Tyler Specialty Average (25.5 Years) 25.5 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
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	21	$103.00	$46.94
99221 Initial hospital inpatient care per day, typically 30 minutes	31	30	$228.00	$78.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	24	$238.00	$121.77
99213 Established patient office or other outpatient visit, typically 15 minutes	19	18	$160.00	$86.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$239.00	$105.75
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$308.00	$123.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$365.00	$159.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	34	21	$103.00	$47.63
99221 Initial hospital inpatient care per day, typically 30 minutes	28	27	$228.00	$79.61
99213 Established patient office or other outpatient visit, typically 15 minutes	25	23	$160.00	$86.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$239.00	$107.21
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$365.00	$153.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	15	$96.00	$54.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$238.00	$122.44
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$308.00	$125.10
49650 Repair of groin hernia using an endoscope	12	11	$1404.67	$421.33

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	45	37	$96.00	$54.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$365.00	$161.28
99231 Follow-up hospital inpatient care per day, typically 15 minutes	22	16	$103.00	$33.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$239.00	$107.92
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	15	$308.00	$124.56
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$228.00	$95.15
47562 Removal of gallbladder using an endoscope	13	13	$1966.00	$495.16
99213 Established patient office or other outpatient visit, typically 15 minutes	12	11	$160.00	$87.82

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	34	33	$96.00	$53.90
99213 Established patient office or other outpatient visit, typically 15 minutes	23	21	$160.00	$89.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$365.00	$163.90

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	46	46	$96.00	$44.16
99213 Established patient office or other outpatient visit, typically 15 minutes	32	32	$160.00	$73.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$239.00	$101.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	98	95	$160.00	$71.40
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	29	$86.12	$43.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$239.00	$103.87
43644 Bypass operation of stomach using an endoscope	22	22	$5306.36	$1701.26
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$90.64	$73.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$365.00	$158.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	11	$238.00	$104.58
43775 Stomach reduction procedure with partial removal of stomach using an endoscope	12	12	$3345.00	$934.91
47562 Removal of gallbladder using an endoscope	11	11	$1966.00	$448.67

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	194	159	$75.05	$39.53
99202 New patient office or other outpatient visit, typically 20 minutes	67	67	$85.00	$67.55
43644 Bypass operation of stomach using an endoscope	33	33	$6500.00	$1542.87
43775 Stomach reduction procedure with partial removal of stomach using an endoscope	13	13	$6000.00	$968.34

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	205	171	$75.10	$38.45
99202 New patient office or other outpatient visit, typically 20 minutes	92	92	$85.00	$66.21
43644 Bypass operation of stomach using an endoscope	36	36	$6486.11	$1519.78
43775 Stomach reduction procedure with partial removal of stomach using an endoscope	30	30	$6000.00	$1002.22
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$200.00	$124.35
47562 Removal of gallbladder using an endoscope	14	14	$2400.00	$406.76

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX L 1797

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

1486250-01 (TX)

Commercial Insurance / Payer ID Bcbs

8S2030 (TX)

Hospital & Practice Group Affiliations

Etmc Physician Group, Inc.

1000 S Beckham Ave, Tyler, TX 757011908

Phone: 9035905611

Etmc Physician Group, Inc.

701 Olympic Plaza Cir, Tyler, TX 757011950

Phone: 9035318109

Etmc Physician Group, Inc.

18118 Fm 344, Flint, TX 757626010

Phone: 9038253292

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Charles Keith , MD

Surgery

NPI 1487098240

Doctor of Medicine (M.D.)

Megan Francis

Nurse Practitioner - Family

NPI 1699314062

Lisa Losack , BSN, CNOR, CRNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1962580241

Bachelor of Science in Nursing, CNOR, CRNFA

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active April 28, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location April 28, 2008

Registered at 1100 E LAKE ST, STE 230, TYLER, TX 757013343 (Tel: 9035930230)

📍

Updated Business Mailing Address April 28, 2008

Registered at 1100 E LAKE ST, STE 230, TYLER, TX 757013343 (Tel: 9035930230)

👤

Provider Name / Credentials Updated April 28, 2008

Recorded as HUGH BABINEAU, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2008

Surgery (License #L 1797 in TX)

🟢

Initial NPI Registration & Enumeration September 27, 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: 1043206774

Entity Type:

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

Enumeration Date: September 27, 2005

Last Update: April 28, 2008

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1100 E Lake St, Ste 230

Tyler, TX 757013343

Phone: 9035930230

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.