Daren Guertin
Foot & Ankle Surgery · Deer Park, TXNPI 1013959477
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (59.2%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. 36 manufacturers reported payments, led by Kerecis Limited at 50.3% of the total. 2025 is the largest year on record at $26,228, more than ten times the $882 reported in 2019. Among foot & ankle surgery clinicians in TX with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 284 payments — averaging $270.74 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Kerecis Limited$39K
- Paratek Pharmaceuticals, Inc.$32K
- Stryker$2K
- Bone Support Inc.$2K
- Smith+Nephew$523
- Ossio Inc$302
- plus $2K from 30 others
What the payments were for
- Consulting fees$3,8755%
- Speaking & faculty fees$45,54359%
- Travel & lodging$16,57122%
- Food & beverage$10,15113%
- Education$7501%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Kerecis Limited | 33 | $38,678 |
| Paratek Pharmaceuticals, Inc. | 130 | $31,898 |
| Stryker(2 entities) | 37 | $1,804 |
| Bone Support Inc. | 5 | $1,531 |
| Smith+Nephew | 26 | $523 |
| Ossio Inc | 1 | $302 |
| Trilliant Surgical LLC. | 3 | $294 |
| Sanara Medtech Inc. | 2 | $289 |
| Paragon 28, Inc. | 3 | $222 |
| Musculoskeletal Transplant Foundation Inc. | 3 | $211 |
| Linvatec Corporation | 1 | $165 |
| Amgen | 1 | $117 |
| Radius Health, Inc. | 5 | $87 |
| Celularity Inc. | 2 | $76 |
| Bioventus LLC | 3 | $74 |
| Ortho Dermatologics, A Division Of Bausch Health US, LLC | 1 | $64 |
| Mimedx Group, Inc. | 3 | $60 |
| Melinta Therapeutics, LLC | 3 | $60 |
| Treace Medical Concepts, Inc. | 3 | $57 |
| Convatec Inc. | 2 | $50 |
| KCI USA, Inc. | 2 | $35 |
| Abbott | 1 | $31 |
| ETS Wound Care LLC | 1 | $29 |
| Medinc Of Texas | 1 | $26 |
| Pacira Pharmaceuticals Incorporated | 1 | $25 |
| ANI Pharmaceuticals, Inc. | 1 | $23 |
| Biotissue Holdings Inc. | 1 | $22 |
| Bard Peripheral Vascular, Inc. | 1 | $18 |
| Osiris Therapeutics Inc. | 1 | $18 |
| Sebela Pharmaceuticals Inc. | 1 | $17 |
| AbbVie | 1 | $16 |
| Orthofix Medical, Inc. | 1 | $16 |
| Medshape, Inc. | 1 | $15 |
| Urgo Medical North America, LLC | 1 | $14 |
| Merck | 1 | $11 |
| Extremity Medical | 1 | $11 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Kerecis Omega3 Marigen$65,436
- Kerecis Omega3 SurgiClose$51,589
- NUZYRA$29,901
- Kerecis SurgiClose$25,708
- Kerecis Omega3 GraftGuide$22,188
- Kerecis Omega3 Wound$7,018
- Kerecis Omega3 Surgibind$6,866
- Kerecis GraftGuide$6,427
- CERAMENTBONE VOID FILLER$1,475
- HOFFMANN$542
- CellerateRx$289
- NeoSpan$165
- BioBrace 23mm$165
- Precision MIS Bunion$150
- KRYSTEXXA$117
How this compares
$76,890 in reported general payments places this provider in the 90th percentile of 684 foot & ankle surgery providers in Texas.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| NuzyraOmadacycline Tosylate | 62 | $478,447 |
| JubliaEfinaconazole | 32 | $42,337 |
| Flucytosine | 12 | $33,211 |
| Linezolid | 15 | $2,020 |
| Ciclopirox | 35 | $1,220 |
| Mupirocin | 130 | $1,149 |
| Clotrimazole | 53 | $890 |
| Terbinafine Hcl | 33 | $752 |
| Gentamicin Sulfate | 15 | $670 |
| Celecoxib | 13 | $276 |
| Gabapentin | 25 | $264 |
| Ciprofloxacin Hcl | 16 | $257 |
| Doxycycline Hyclate | 18 | $234 |
| Fluconazole | 18 | $232 |
| Ammonium Lactate | 11 | $219 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Paratek Pharmaceuticals, Inc.Nuzyra | $31,898 | $478,44762 claims |
| Ortho Dermatologics, A Division Of Bausch Health US, LLCJublia | $64 | $42,33732 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 90th percentile of 684 foot & ankle surgery providers in Texas.
Other foot & ankle surgery in Deer Park
- William McGarveyKaty$3.5M
- Eugene CurryDallas$3.1M
- Graham HamiltonEdinburg$2.1M
- Mark DaltonAustin$1.9M
- Kevin VarnerHouston$1.1M
- Paul KimDallas$928K
- Sherman NaglerHouston$602K
- John EarlyDallas$553K
- Michael DowneySouthlake$475K
- Abdul NurudeenHouston$404K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.