DR. LEONEL G MORENO M.D. NPI 1013077213
Family Medicine in Mcallen, TX

About DR. LEONEL G MORENO M.D.

Leonel Moreno is a primary care provider established in Mcallen, Texas and his medical specialization is Family Medicine with more than 34 years of experience. The NPI number of Leonel Moreno is 1013077213 and was assigned on December 2006. The practitioner's primary taxonomy code is 207Q00000X with license number J9224 (TX). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1013077213
Provider NameDR. LEONEL G MORENO M.D.
Location Address606 S BROADWAY AVENUE MCALLEN, TX 78501
Location Phone(956) 682-4515
Mailing Address606 S BROADWAY AVENUE MCALLEN, TX 78501
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1989
Is Sole Proprietor?No
Enumeration Date12-11-2006
Last Update Date09-03-2019

A primary care provider (PCP) like Dr. Leonel G Moreno M.d. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc Leonel Moreno 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.

Leonel Moreno 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 Doctors Hospital At Renaissance.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 86.8, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: annual registration in the prescription drug monitoring program, documentation of current medications in the medical record, engagement of patients through implementation of improvements in patient portal, e-prescribing, immunization registry reporting, implementation of improvements that contribute to more timely communication of test results, improved practices that engage patients pre-visit, practice improvements for bilateral exchange of patient information, preventive care and screening: body mass index (bmi) screening and follow-up plan, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patients electronic access to their health information, query of the prescription drug monitoring program (pdmp), security risk analysis, statin therapy for the prevention and treatment of cardiovascular disease, support electronic referral loops by sending health information, syndromic surveillance reporting and use of certified ehr to capture patient reported outcomes.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.84 for a new patient copayment and $25.3 for an established patient copayment.



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 Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.J9224
License StateTX
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. LEONEL G MORENO M.D.
606 S BROADWAY AVENUE
MCALLEN, TX
ZIP 78501
Phone: (956) 682-4515
Fax: (956) 662-7628

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Mailing Address

DR. LEONEL G MORENO M.D.
606 S BROADWAY AVENUE
MCALLEN, TX
ZIP 78501
Phone: (956) 682-4515
Fax: (956) 622-7628


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 ID749315794
PECOS Enrollment IDI20100317000095
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

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 78501 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.75 $172.6 $87.36
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.15 $21.84
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.72 $141.29 $101.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.43 $35.32 $25.3

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 77.4
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 97
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 86.8
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Documentation of Current Medications in the Medical Record 98% 4666
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
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing 99% 10355
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
Implementation of improvements that contribute to more timely communication of test resultsYesN/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Improved Practices that Engage Patients Pre-VisitYesN/A
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient's appointment..
Practice Improvements for Bilateral Exchange of Patient InformationYesN/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: - Participate in a Health Information Exchange if available; and/or - Use structured referral notes.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 23% 2135
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 encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/A
- Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following:- Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care);- Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/orProvision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patients Electronic Access to Their Health Information 81% 2812
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Query of the Prescription Drug Monitoring Program (PDMP)YesN/A
For at least one Schedule II opioid electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a Prescription Drug Monitoring Program (PDMP) for prescription drug history, except where prohibited and in accordance with applicable law.
Security Risk AnalysisYesN/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 electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 63% 372
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period:*Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR*Adults aged >= 21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia; OR*Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL
Support Electronic Referral Loops By Sending Health Information 100% 60
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider - (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
Syndromic Surveillance ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data from an urgent care setting.
Use of certified EHR to capture patient reported outcomesYesN/A
In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review.

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.

  • 1100Injection, dexamethasone sodium phosphate, 1mg (HCPCS:J1100)
  • 398Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • 140Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 76Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • 55Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 53Hemoglobin A1C level (HCPCS:83036)
  • 51X-ray of chest, 2 views, front and side (HCPCS:71020)
  • 16Administration of influenza virus vaccine (HCPCS:G0008)
  • 13Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

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. Leonel Moreno is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
DOCTORS HOSPITAL AT RENAISSANCE5501 SOUTH MCCOLL
EDINBURG, TX 78539
(956) 362-8677Acute Care Hospitals450869

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.
1013077213
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023071422
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 7 + 1 + 4 + 2 + 2 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1013077213 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

What is Dr. Leonel Moreno M.D. NPI number?

The NPI number assigned to Dr. Leonel Moreno M.D. is 1013077213, registered as an "individual" on December 11, 2006

Where is Dr. Leonel Moreno M.D. located?

The provider is located at 606 S Broadway Avenue Mcallen, Tx 78501 and the phone number is (956) 682-4515

Which is Dr. Leonel Moreno M.D. specialty?

The provider's speciality is Family Medicine

How many years of experience does Dr. Leonel Moreno M.D. have?

The provider has more than 34 years of experience.

Is Dr. Leonel Moreno M.D. registered in PECOS?

Yes, as of November 14, 2022 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.

How much is a visit to Dr. Leonel Moreno M.D.?

Medicare beneficiaries should expect a typical cost of $87.36 with an average copayment of $21.84 for new patient appointments. Established patients should expect a typical charge of $101.2 and an average copayment of 25.3. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Leonel Moreno M.D.?

The most common procedures or services performed by this practitioner are: Injection, dexamethasone sodium phosphate, 1mg, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Insertion of needle into vein for collection of blood sample, Complete blood cell count (red cells, white blood cell, platelets), automated test, Routine EKG using at least 12 leads including interpretation and report, Hemoglobin A1C level, X-ray of chest, 2 views, front and side, Administration of influenza virus vaccine and Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit.

Is Dr. Leonel Moreno M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: 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. Leonel Moreno M.D. was last updated on December 11, 2006. 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]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]