DR. DIANA MARISA DELVALLE M.D. NPI 1013079441
Otolaryngology in Boca Raton, FL

About DR. DIANA MARISA DELVALLE M.D.

Diana Delvalle is a provider established in Boca Raton, Florida and her medical specialization is Otolaryngology with more than 23 years of experience. The NPI number of Diana Delvalle is 1013079441 and was assigned on December 2006. The practitioner's primary taxonomy code is 207Y00000X with license number 224871 (NY). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI
1013079441
Provider NameDR. DIANA MARISA DELVALLE M.D.
Location Address900 NW 13TH ST SUITE 206 BOCA RATON, FL 33486
Location Phone(561) 338-3267
Mailing Address900 NW 13TH ST SUITE 206 BOCA RATON, FL 33486
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2000
Is Sole Proprietor?No
Enumeration Date12-14-2006
Last Update Date07-08-2013

Diana Delvalle 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.

Diana Delvalle 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 she has hospital affiliations with Boca Raton Regional Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 86.7, 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: adult sinusitis: antibiotic prescribed for acute viral sinusitis (overuse), collection and follow-up on patient experience and satisfaction data on beneficiary engagement and provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.66 for a new patient copayment and $19.1 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 Code207Y00000X
ClassificationOtolaryngology
TypeAllopathic & Osteopathic Physicians
License No.224871
License StateNY
Taxonomy DescriptionAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. DIANA MARISA DELVALLE M.D.
900 NW 13TH ST
SUITE 206
BOCA RATON, FL
ZIP 33486
Phone: (561) 338-3267

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Mailing Address

DR. DIANA MARISA DELVALLE M.D.
900 NW 13TH ST
SUITE 206
BOCA RATON, FL
ZIP 33486
Phone: (561) 338-3267


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 ID3476599721
PECOS Enrollment IDI20070602000017
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 33486 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
$61.36 $187 $94.64
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$15.34 $46.75 $23.66
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.68 $151.65 $76.4
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.67 $37.91 $19.1

* 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% 82.6
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% N/A
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 - 86.7
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
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse) 48% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
257
Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms
Collection and follow-up on patient experience and satisfaction data on beneficiary engagementYesN/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
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.

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.

  • 1299Injection of allergenic extracts into skin, accessed through the skin (HCPCS:95004)
  • 698Removal of impact ear wax, one ear (HCPCS:69210)
  • 646Injection of allergenic extracts into skin for immediate reaction analysis (HCPCS:95024)
  • 307Diagnostic examination of voice box using flexible endoscope (HCPCS:31575)
  • 272Diagnostic examination of nasal passages using an endoscope (HCPCS:31231)
  • 101Assessment and recording of balance system during irrigation of both ears (HCPCS:92543)
  • 27Observation, testing, and recording of abnormal eye movement (HCPCS:92540)

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. Diana Delvalle is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
BOCA RATON REGIONAL HOSPITAL800 MEADOWS RD
BOCA RATON, FL 33486
(561) 362-5002Acute Care Hospitals100168

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
I32494MEDICARE UPIN (02)FL
02670919MEDICAID (05)NY
AD056YMEDICARE PIN (08)FL

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.
1013079441
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023071848
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 + 8 + 4 + 8 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1013079441 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1982672861 JOHN T BOWMAN DMD,MD
Individual
Dentist (Oral and Maxillofacial Pathology)900 NW 13TH ST
BOCA RATON, FL 33486
(561) 391-6234
1750345500DR. WILLIAM W MCCLERKIN MD
Individual
Specialist900 NW 13TH ST SUITE 206
BOCA RATON, FL 33486
(561) 391-3333
1265496012DR. BRIAN C MITCHELL MD
Individual
Specialist900 NW 13TH ST SUITE 206
BOCA RATON, FL 33486
(561) 391-3333
1356456495 JANE PISKIN
Individual
Occupational Therapist900 NW 13TH ST SUITE 305
BOCA RATON, FL 33486
(561) 750-7633
1477615409DR. PATRICIA L RAMOS AU.D
Individual
Audiologist900 NW 13TH ST SUITE 206
BOCA RATON, FL 33486
(561) 391-3333
1710049762 TRISHA DAWN FORMICHETTI AU.D
Individual
Audiologist900 NW 13TH ST SUITE 206
BOCA RATON, FL 33486
(561) 391-3333
1417009150DR. JOHN ROBERT MAGNACCA DDS
Individual
Dentist (Oral and Maxillofacial Surgery)900 NW 13TH ST SUITE 202
BOCA RATON, FL 33486
(561) 391-6234
1750425161GERARD M. CUOMO, D.D.S., P.A.
Organization
Dentist (General Practice)900 NW 13TH ST SUITE 301
BOCA RATON, FL 33486
(561) 391-6290
1033253448DR. GERARD MICHAEL CUOMO D.D.S
Individual
Dentist (General Practice)900 NW 13TH ST SUITE 300
BOCA RATON, FL 33486
(561) 391-6290
1275758344DR. CAROLINA STEIER D.M.D
Individual
Dentist (Prosthodontics)900 NW 13TH ST SUITE 300
BOCA RATON, FL 33486
(561) 395-3190
1821288564ORTHOTIC & PROSTHETIC CENTER OF ST. PETERSBURG
Organization
Durable Medical Equipment & Medical Supplies (Customized Equipment)900 NW 13TH ST SUITE # 107
BOCA RATON, FL 33486
(561) 394-4200
1740452325EAST BOCA DENTAL IMPLANTS&PROSTHODONTICS
Organization
Dentist (Prosthodontics)900 NW 13TH ST SUITE 300
BOCA RATON, FL 33486
(561) 395-3190
1417123522 ANIA DANIELLE CARLSON MD
Individual
Anesthesiology (Pain Medicine)900 NW 13TH ST SUITE 302
BOCA RATON, FL 33486
(561) 362-2969
1518120930JOSE V CASTELLANOS MD PLLC
Organization
Internal Medicine900 NW 13TH ST SUITE 203
BOCA RATON, FL 33486
(561) 391-5993
1275831224MARIA S. WOZNIAK M.D.
Organization
Internal Medicine900 NW 13TH ST SUITE 303
BOCA RATON, FL 33486
(561) 620-9004
1568643286VERHEES & ASSOCIATES PHYSICAL THERAPY INSTITUTE INC
Organization
Physical Therapist900 NW 13TH ST SUITE #104
BOCA RATON, FL 33486
(561) 394-0214
1881859049DR. DANIEL T GANC M.D.
Individual
Otolaryngology900 NW 13TH ST SUITE 206
BOCA RATON, FL 33486
(561) 391-3333
1396112447 ALEXIS HEFFNER
Individual
Audiologist900 NW 13TH ST 206
BOCA RATON, FL 33486
(561) 338-3267
1528523784HEADSTART CLINICS LLC
Organization
Prosthetic/Orthotic Supplier900 NW 13TH ST
BOCA RATON, FL 33486
(561) 702-3094
1912341744W R ROSEN INC
Organization
Prosthetic/Orthotic Supplier900 NW 13TH ST STE 105
BOCA RATON, FL 33486
(561) 409-3685

Frequently Asked Questions

What is Dr. Diana Delvalle M.D. NPI number?

The NPI number assigned to Dr. Diana Delvalle M.D. is 1013079441, registered as an "individual" on December 14, 2006

Where is Dr. Diana Delvalle M.D. located?

The provider is located at 900 Nw 13th St Suite 206 Boca Raton, Fl 33486 and the phone number is (561) 338-3267

Which is Dr. Diana Delvalle M.D. specialty?

The provider's speciality is Otolaryngology

How many years of experience does Dr. Diana Delvalle M.D. have?

The provider has more than 23 years of experience.

What insurance does Dr. Diana Delvalle M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Diana Delvalle 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. Diana Delvalle M.D.?

Medicare beneficiaries should expect a typical cost of $94.64 with an average copayment of $23.66 for new patient appointments. Established patients should expect a typical charge of $76.4 and an average copayment of 19.1. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Diana Delvalle M.D.?

The most common procedures or services performed by this practitioner are: Injection of allergenic extracts into skin, accessed through the skin, Removal of impact ear wax, one ear, Injection of allergenic extracts into skin for immediate reaction analysis, Diagnostic examination of voice box using flexible endoscope, Diagnostic examination of nasal passages using an endoscope, Assessment and recording of balance system during irrigation of both ears and Observation, testing, and recording of abnormal eye movement.

Is Dr. Diana Delvalle M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: BOCA RATON REGIONAL HOSPITAL. 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. Diana Delvalle M.D. was last updated on December 14, 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]