DR. MARIO JOSEPH QUESADA M.D. NPI 1003018086

Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery) in Brownsville, TX

NPI 1003018086 Individual Male Years of Experience 21 Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About MARIO QUESADA

Mario Quesada is a provider established in Brownsville, Texas and his medical specialization is orthopaedic surgery (adult reconstructive orthopaedic surgery) with more than 21 years of experience. He graduated from University Of Southern California Keck School Of Medicine in 2001. The NPI number of Mario Quesada 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 6 years ago.

Mario Quesada is enrolled in PECOS and is eligible to order or refer healthcare 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, Doctors Hospital At Renaissance and Valley Regional Medical Center.

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, e-prescribing exclusion, health information exchange exclusion, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, onc direct review attestation, onc-acb surveillance attestation (optional), 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, preventive care and screening: tobacco use: screening and cessation intervention, preventive care and screening: tobacco use: screening and cessation intervention, provide patient access, security risk analysis, specialized registry reporting, specialized registry reporting for multiple registry engagement, use of decision support and standardized treatment protocols and view, download, or transmit (vdt). The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1003018086

Provider NameDR. MARIO JOSEPH QUESADA M.D.
Provider Location Address1201 E ALTON GLOOR BLVD SUITE B BROWNSVILLE, TX 78526
Provider Mailing Address1203E ALTON GLOOR BLVD BROWNSVILLE, TX 78526
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduation Year2001
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-01-2007
Last Update Date10-07-2015


Primary Taxonomy

Taxonomy Code207XS0114X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
SpecializationAdult Reconstructive Orthopaedic Surgery
License No.Q1711
License StateTX
Taxonomy DescriptionRecognized 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.

Business Address

DR. MARIO JOSEPH QUESADA M.D.
1201 E ALTON GLOOR BLVD
SUITE B
BROWNSVILLE, TX
ZIP 78526
Phone: (956) 544-2663
Fax: (956) 542-2366

Get Directions


Mailing Address

DR. MARIO JOSEPH QUESADA M.D.
1203E ALTON GLOOR BLVD
BROWNSVILLE, TX
ZIP 78526
Phone: (956) 544-2663
Fax: (956) 542-2366



Medicare Participation

Registered in PECOS? Yes 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.
PECOS PAC ID9931285897
PECOS Enrollment IDI20150720002702
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

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.

  • 30X-ray of ribs of one side of body, minimum of 2 views (HCPCS:73510)
  • 26X-ray of knee, 3 views (HCPCS:73562)
  • 21Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • 13X-ray of shoulder, minimum of 2 views (HCPCS:73030)

Quality Reporting

The following quality measures meets 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 Rate Number of Patients
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
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 96% 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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 7% 44
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.
View, Download, or Transmit (VDT) 13% 1308
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

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- BROWNSVILLE1040 W JEFFERSON ST
BROWNSVILLE, TX 78520
(956) 544-1400Acute Care Hospitals450028
DOCTORS HOSPITAL AT RENAISSANCE5501 SOUTH MCCOLL
EDINBURG, TX 78539
(956) 362-8677Acute Care Hospitals450869
VALLEY REGIONAL MEDICAL CENTER100 A ALTON GLOOR
BROWNSVILLE, TX 78526
(956) 350-7000Acute Care Hospitals450662

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
1207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryMD200497LANo

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.

2207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery13888NVNo

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
1237710MEDICAID (05)LA

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 Assistant1201 E ALTON GLOOR BLVD
BROWNSVILLE, TX 78526
(956) 542-2325
1164099693 ANDRES AVILA
Individual
Physician Assistant1201 E ALTON GLOOR BLVD
BROWNSVILLE, TX 78526
(956) 542-2325

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
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.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.