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CARLA FRANCESCA JUSTINIANO M.D.
NPI 1073930517
Colon & Rectal Surgery in Cincinnati, OH

Active since March 22, 2014PECOS EnrolledAccepts Medicare Assignment
78.78/100
CMS Quality Rating
222 PIEDMONT AVE, CINCINNATI, OH 45219(513) 929-0104(513) 929-4369 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carla Francesca Justiniano M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLA FRANCESCA JUSTINIANO M.D. (NPI 1073930517) is an individual colon & rectal surgery provider in Cincinnati, Ohio, licensed in Ohio (35.144741) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with University Of Cincinnati Medical Center, Llc, and is a graduate of Ohio State University College Of Medicine (2014).

NPPES Registry Identity

NPI1073930517
Entity TypeIndividualFemale
Primary Taxonomy208C00000X
Provider Legal NameCARLA FRANCESCA JUSTINIANOCredential: M.D.
Location Address222 PIEDMONT AVECincinnati, OH 45219-4231
Mailing AddressPo Box 636256Cincinnati, OH 45263-6256 · (513) 558-5162 · Fax (513) 245-3672
Phone(513) 929-0104
Fax(513) 929-4369
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2014
Enumeration DateMarch 22, 2014
Last NPPES UpdateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
✔ NPI 1073930517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in OH · 35.144741
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
222 PIEDMONT AVE, Cincinnati, OH 45219
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carla Francesca Justiniano M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769772441
PECOS Enrollment IDI20220722002143
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
16 services15 patients
Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Cincinnati Medical Center, LLC

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360003
Location3188 Bellevue AvenueCincinnati, OH 45219 · Hamilton County
Emergency services Birthing friendly

Christ Hospital

Acute Care Hospitals · Cincinnati, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360163
Location2139 Auburn AvenueCincinnati, OH 45219 · Hamilton County
Emergency services Birthing friendly

West Chester Hospital

Acute Care Hospitals · West Chester, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360354
Location7700 University DriveWest Chester, OH 45069 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.42
Promoting Interoperability100
Improvement Activities40
Cost58.86

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BERNICE K KLABEN PH.D.-CCC-SLP-BRS-S
Speech-Language Pathologist
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-8400
BARBARA RUTH CUNNINGHAM RN
Allergy & Immunology (Clinical & Laboratory Immunology)
222 PIEDMONT AVE, SUITE 5200
CINCINNATI, OH 45219
Hamilton County (513) 475-8400
MRS. CHERYL DOREEN HERRLE CNP
Nurse Practitioner (Gerontology)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7400
REBECCA HARDT CNP
Nurse Practitioner (Adult Health)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7505
MRS. RONDA BAUER
Licensed Practical Nurse
222 PIEDMONT AVE, SUITE 5200
CINCINNATI, OH 45219
Hamilton County (513) 475-7363
CARRIE LYNN JENNINGS CNP
Nurse Practitioner (Family)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7505
ALBERTO ESPAY MD
Psychiatry & Neurology (Neurology)
222 PIEDMONT AVE, SUITE 3200
CINCINNATI, OH 45219
Hamilton County (513) 475-8730
GREGORY WAYNE ROUAN M.D.
Internal Medicine
222 PIEDMONT AVE, STE 6000
CINCINNATI, OH 45219
Hamilton County (513) 475-7880

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carla Justiniano's NPI number?

The NPI number for Carla Justiniano is 1073930517. It was assigned to this individual provider in the NPPES registry on March 22, 2014.

Where is Carla Justiniano located?

Carla Justiniano practices at 222 Piedmont Ave, Cincinnati, OH 45219. The listed phone number is (513) 929-0104.

What is Carla Justiniano's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Carla Justiniano enrolled in Medicare?

Yes. Carla Justiniano is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carla Justiniano accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance list Carla Justiniano as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carla Justiniano affiliated with any hospitals?

According to CMS data, Carla Justiniano is affiliated with University Of Cincinnati Medical Center, LLC, Christ Hospital and West Chester Hospital.

When was this NPI record last updated?

The NPPES record for Carla Justiniano was last updated on March 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.