DR. MARIO JOSEPH QUESADA M.D. NPI 1003018086
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Brownsville, TX
About DR. MARIO JOSEPH QUESADA M.D.
Mario Quesada is a provider established in Brownsville, Texas and his medical specialization is Orthopaedic Surgery with a focus in adult reconstructive orthopaedic surgery with more than 22 years of experience. He graduated from University Of Southern California Keck School Of Medicine in 2001. The NPI number of this provider is 1003018086 and was assigned on June 2007. The practitioner's primary taxonomy code is 207XS0114X with license number Q1711 (TX). The provider is registered as an individual and his NPI record was last updated 8 years ago.
| NPI | 1003018086 |
| Provider Name | DR. MARIO JOSEPH QUESADA M.D. |
| Location Address | 1201 E ALTON GLOOR BLVD SUITE B BROWNSVILLE, TX 78526 |
| Location Phone | (956) 544-2663 |
| Mailing Address | 1203E ALTON GLOOR BLVD BROWNSVILLE, TX 78526 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Is Sole Proprietor? | No |
| Enumeration Date | 06-01-2007 |
| Last Update Date | 10-07-2015 |
Mario Quesada is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Mario Quesada is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Valley Baptist Medical Center- Brownsville, Valley Regional Medical Center and Doctors Hospital At Renaissance.
The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: chronic care and preventative care management for empaneled patients, documentation of current medications in the medical record, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, patient-specific education, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: tobacco use: screening and cessation intervention, provide patient access, security risk analysis, specialized registry reporting and use of decision support and standardized treatment protocols. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207XS0114X |
| Classification | Orthopaedic Surgery |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| License No. | Q1711 |
| License State | TX |
| Taxonomy Description | Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
1201 E ALTON GLOOR BLVD
SUITE B
BROWNSVILLE, TX
ZIP 78526
Phone: (956) 544-2663
Fax: (956) 542-2366
Mailing Address
1203E ALTON GLOOR BLVD
BROWNSVILLE, TX
ZIP 78526
Phone: (956) 544-2663
Fax: (956) 542-2366
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9931285897 |
| PECOS Enrollment ID | I20150720002702 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Documentation of Current Medications in the Medical Record | 100% | 2839 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 856 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 66% | 1308 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 18% | 1151 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 88% | 534 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 37% | 1308 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 82X-ray of shoulder, minimum of 2 views (HCPCS:73030)
- 73Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
- 58Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
- 57X-ray of hip with pelvis, 2-3 views (HCPCS:73502)
- 40X-ray of knee, 3 views (HCPCS:73562)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mario Quesada is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| VALLEY BAPTIST MEDICAL CENTER- BROWNSVILLE | 1040 W JEFFERSON ST BROWNSVILLE, TX 78520 | (956) 544-1400 | Acute Care Hospitals | 450028 | |
| VALLEY REGIONAL MEDICAL CENTER | 100 A ALTON GLOOR BROWNSVILLE, TX 78526 | (956) 350-7000 | Acute Care Hospitals | 450662 | |
| DOCTORS HOSPITAL AT RENAISSANCE | 5501 SOUTH MCCOLL EDINBURG, TX 78539 | (956) 362-8677 | Acute Care Hospitals | 450869 |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207XP3100X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Pediatric Orthopaedic Surgery | MD200497 | LA | No |
Taxonomy Description: an orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. | |||||||
| 2 | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | 13888 | NV | No |
Taxonomy Description: recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 1237710 | MEDICAID (05) | LA |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 8 | 0 | 8 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 16 | 0 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 1 + 6 + 0 + 1 + 6 + 24 = 44 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 44 = 6 | 6 | ||||||||
The NPI number 1003018086 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1255863890 | ANDREA FRAGOSO SANTANA PA-C Individual | Physician Assistant | 1201 E ALTON GLOOR BLVD BROWNSVILLE, TX 78526 (956) 542-2325 |
| 1164099693 | ANDRES AVILA Individual | Physician Assistant | 1201 E ALTON GLOOR BLVD BROWNSVILLE, TX 78526 (956) 542-2325 |
Frequently Asked Questions
What is Dr. Mario Quesada M.D. NPI number?
The NPI number assigned to this healthcare provider is 1003018086, registered as an "individual" on June 01, 2007
Where is Dr. Mario Quesada M.D. located?
The provider is located at 1201 E Alton Gloor Blvd Suite B Brownsville, Tx 78526 and the phone number is (956) 544-2663
Which is Dr. Mario Quesada M.D. specialty?
The provider's speciality is Orthopaedic Surgery with a focus in Adult Reconstructive Orthopaedic Surgery
How many years of experience does Dr. Mario Quesada M.D. have?
The provider has more than 22 years of experience. He graduated from University Of Southern California Keck School Of Medicine in 2001.
What insurance does Dr. Mario Quesada M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Mario Quesada M.D. registered in PECOS?
Yes, as of May 11, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are some of the services provided by Dr. Mario Quesada M.D.?
The most common procedures or services performed by this practitioner are: X-ray of shoulder, minimum of 2 views, Aspiration and/or injection of large joint or joint capsule, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, X-ray of hip with pelvis, 2-3 views and X-ray of knee, 3 views.
Is Dr. Mario Quesada M.D. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: VALLEY BAPTIST MEDICAL CENTER- BROWNSVILLE, VALLEY REGIONAL MEDICAL CENTER and DOCTORS HOSPITAL AT RENAISSANCE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Mario Quesada M.D. was last updated on June 01, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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