Active NPI 1205192994 Individual Practitioner Male Practitioner

Dr. Paul Michael Claiborne , MD

Surgery • Waco, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Paul Claiborne, MD is a certified Surgery practicing in Waco, TX. With approximately 14 years of clinical experience since graduating from University Of Texas Medical School At Houston in 2012, Dr. Claiborne delivers high-quality medical care to the local community at 6600 FISH POND RD STE 101.

Dr. Claiborne is affiliated with Providence Health Alliance and accepts Medicare assignment.

Frequently performed procedures and clinical services include initial hospital care with straightforward or low-level medical decision making, if using time, at least, new patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6600 Fish Pond Rd Ste 101

Waco, TX 767102582

Telephone 2547763188

Fax 2547763607

Associated Practice Facility / Clinic

🏢 Waco Surgical Clinic P A Facility NPI 1598844367

Medicare Profile & Education

Medical School

University Of Texas Medical School At Houston

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Waco, TX

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs -4.4 yrs vs City Avg

City Avg: 18.4 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

17 Specialists

Practicing in Waco, TX (2342 Statewide)

Telehealth Adoption Rate

5.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Claiborne (14 Years) 14 Yrs

Waco Specialty Average (18.4 Years) 18.4 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
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	37	36	$404.31	$125.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$313.98	$103.73
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	21	12	$308.55	$113.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$478.83	$151.99
10005 Fine needle aspiration of first lesion using ultrasound guidance	18	18	$371.55	$127.70
99213 Established patient office or other outpatient visit, typically 15 minutes	18	18	$212.55	$82.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$598.89	$165.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$313.23	$123.05
47562 Removal of gallbladder using an endoscope	13	13	$1951.68	$605.90

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	37	37	$478.83	$154.72
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	28	28	$404.31	$126.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$313.98	$103.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	22	$313.23	$120.48
99213 Established patient office or other outpatient visit, typically 15 minutes	21	19	$212.55	$87.24
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	20	12	$308.55	$115.44
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$598.89	$168.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$126.18	$54.55
47562 Removal of gallbladder using an endoscope	12	12	$1951.68	$632.80
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	$603.60	$212.31
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	11	11	$56.52	$17.33
10005 Fine needle aspiration of first lesion using ultrasound guidance	11	11	$371.55	$131.47

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	56	56	$313.98	$106.12
99221 Initial hospital inpatient care per day, typically 30 minutes	33	33	$299.28	$95.69
99213 Established patient office or other outpatient visit, typically 15 minutes	20	16	$212.55	$87.74
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	14	$598.89	$190.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	14	$126.18	$53.61
47562 Removal of gallbladder using an endoscope	14	14	$1951.68	$630.44
10005 Fine needle aspiration of first lesion using ultrasound guidance	12	12	$371.55	$134.84
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	12	11	$3125.13	$317.42
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	12	11	$56.52	$17.71

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	55	55	$313.98	$105.30
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	22	$126.18	$54.93
99213 Established patient office or other outpatient visit, typically 15 minutes	26	25	$212.55	$89.35
99221 Initial hospital inpatient care per day, typically 30 minutes	20	20	$299.28	$92.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$478.83	$163.86
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$404.31	$131.78
49324 Insertion of abdominal cavity catheter using an endoscope	12	12	$1156.20	$311.71
47562 Removal of gallbladder using an endoscope	11	11	$1951.68	$636.94

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	64	64	$313.98	$104.38
99213 Established patient office or other outpatient visit, typically 15 minutes	25	21	$212.55	$71.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	18	$126.18	$42.37
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$404.31	$136.85
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$299.28	$101.68
49422 Removal of abdominal cavity catheter	11	11	$1130.10	$136.65
47562 Removal of gallbladder using an endoscope	11	11	$1951.68	$656.63

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	68	68	$313.98	$104.00
99213 Established patient office or other outpatient visit, typically 15 minutes	34	32	$212.55	$71.44
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	32	31	$404.31	$133.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	22	$126.18	$42.02
47562 Removal of gallbladder using an endoscope	13	13	$1951.68	$645.20
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	11	11	$3125.13	$293.32

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	96	96	$313.98	$103.14
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	39	39	$404.31	$129.10
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	33	32	$598.89	$187.10
47562 Removal of gallbladder using an endoscope	19	19	$1951.68	$643.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	19	$126.18	$42.13
99213 Established patient office or other outpatient visit, typically 15 minutes	16	16	$212.55	$70.30

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	26	26	$288.79	$102.74
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$300.46	$124.37

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX R2307

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Providence Health Alliance

340 Richland W Cir, Waco, TX 767127919

Phone: 2545376050

Providence Health Alliance

342 Richland W Cir, Waco, TX 767127919

Phone: 2545376600

Providence Health Alliance

6901 Medical Pkwy, Waco, TX 767127910

Phone: 2547514000

Providence Health Alliance

301 Richland W Cir, Waco, TX 767127932

Phone: 2545376200

Providence Health Alliance

6600 Fish Pond Rd, Waco, TX 767102582

Practice Associates & Co-Workers

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

8 Associated Practitioners

Dr. William Turney , MD

Surgery

NPI 1093714313

Doctor of Medicine (M.D.)

Dr. Josh Goldstrich , MD

Surgery

NPI 1134265580

Doctor of Medicine (M.D.)

Dr. Karen Burnett , MD

Surgery

NPI 1144424060

Doctor of Medicine (M.D.)

Dr. Ross Reagan , MD

Surgery

NPI 1518966837

Doctor of Medicine (M.D.)

Dr. Gayland Sims , MD

Surgery

NPI 1679572945

Doctor of Medicine (M.D.)

Dr. Elizbeth Kiraly , MD

Surgery

NPI 1710986112

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

12 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Student in an Organized Health Care Education/Training Program

✅

NPI Profile Active August 01, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location August 01, 2017

Registered at 6600 FISH POND RD STE 101, WACO, TX 767102582 (Tel: (254) 776-3188)

📍

Updated Business Mailing Address August 01, 2017

Registered at 6600 FISH POND RD STE 101, WACO, TX 767102582 (Tel: (254) 776-3188)

👤

Provider Name / Credentials Updated August 01, 2017

Recorded as PAUL CLAIBORNE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2017

Surgery (License #R2307 in TX)

✅

NPI Profile Active April 06, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location April 06, 2012

Registered at 1802 E 19TH ST, TULSA, OK 741045403 (Tel: 9187443908)

📍

Updated Business Mailing Address April 06, 2012

Registered at 6301 ALMEDA RD, APT. 932, HOUSTON, TX 770211100 (Tel: 8177915551)

👤

Provider Name / Credentials Updated April 06, 2012

Recorded as PAUL CLAIBORNE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2012

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration April 06, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1205192994

Entity Type:

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

Enumeration Date: April 06, 2012

Last Update: July 21, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6600 Fish Pond Rd Ste 101

Waco, TX 767102582

Phone: 2547763188

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.