FERNANDO ESPARZA MD
NPI 1083651178
Family Medicine in Miami, FL

Q: What is Fernando Esparza's NPI number?

The NPI number for Fernando Esparza is 1083651178. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Q: What is Fernando Esparza's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Fernando Esparza was last updated on February 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since May 31, 2006PECOS EnrolledAccepts Medicare Assignment

91.97/100

CMS Quality Rating

2698 SW 87TH AVE, MIAMI, FL 33165(305) 461-4417(305) 461-4685 Get Directions Write a Review

NPPES record last updated: February 3, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Fernando Esparza Md NPPES

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

FERNANDO ESPARZA MD (NPI 1083651178) is an individual family medicine provider in Miami, Florida, licensed in Florida (ME58429) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1970).

NPPES Registry Identity

NPI1083651178

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameFERNANDO ESPARZACredential: MD

Location Address2698 SW 87TH AVEMiami, FL 33165-2000

Mailing Address2698 Sw 87th AveMiami, FL 33165-2000 · (305) 461-4417

Phone(305) 461-4417

Fax(305) 461-4685

Sole ProprietorYes

Medical School CMSOtherGraduated 1970

Enumeration DateMay 31, 2006

Last NPPES UpdateFebruary 3, 2012

✔ NPI 1083651178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · ME58429

Definition

Family 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.

2698 SW 87TH AVE, Miami, FL 33165

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Other Identifiers 2

Medicare ID-Type Unspecified11226FL

Medicare PIN11226CFL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.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

Fernando Esparza Md 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 ID7810958576

PECOS Enrollment IDI20041026000113

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 11

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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

964 services283 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

554 services216 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

384 services242 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

159 services159 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

156 services61 patients

Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes 99345

A new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.

116 services116 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

89 services71 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

64 services32 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

64 services64 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

32 services18 patients

Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347

An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.

25 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33165 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

$96.13 typical visit price

range $60.92 – $187.05

Typical copayment $24.03 (range $15.23 – $46.76)

Most-billed visit code 99203

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

Most-billed visit code 99214

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.

91.97/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

100

Improvement Activities

Cost

39.91

Reported Quality Measures

Controlling High Blood Pressure

87%78 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Antiplatelet Therapy

100%168 patients5/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

11%27 patients4/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

100%2,530 patients5/55-star benchmark: 100%

Falls: Plan of Care

100%57 patients

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

100%361 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 26

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233

DME-Other DME · category DE017N

1 supplier18 claims36 services$0.42 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers247 claims683 services$5.85 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

3 suppliers91 claims91 services$2.48 avg. paid by Medicare

Spring-powered device for lancet, each A4258

DME-Other DME · category DE000N

4 suppliers25 claims25 services$1.65 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

11 suppliers233 claims323 services$1.02 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

4 suppliers57 claims72 services$1.11 avg. paid by Medicare

Aerosol mask, used with dme nebulizer A7015

DME-Other DME · category DE000N

2 suppliers51 claims51 services$1.10 avg. paid by Medicare

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

1 supplier16 claims16 services$32.50 avg. paid by Medicare

Seat attachment, walker E0156

DME-Other DME · category DE000N

1 supplier15 claims15 services$9.78 avg. paid by Medicare

Gel or gel-like pressure pad for mattress, standard mattress length and width E0185

DME-Other DME · category DE000N

1 supplier36 claims36 services$124.88 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

4 suppliers329 claims329 services$42.40 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261

DME-Hospital Beds · category DB000N

2 suppliers36 claims36 services$33.62 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers168 claims168 services$14.09 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers178 claims178 services$4.23 avg. paid by Medicare

Home blood glucose monitor E0607

DME-Other DME · category DE017N

6 suppliers27 claims27 services$48.25 avg. paid by Medicare

Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038

DME-Other DME · category DE000N

2 suppliers20 claims20 services$5.31 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers168 claims168 services$69.61 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary G0333

DME-Other DME · category DE000N

5 suppliers14 claims14 services$35.28 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

7 suppliers106 claims18,267 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers15 claims1,680 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

2 suppliers41 claims2,400 services$0.61 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

8 suppliers93 claims2,968 services$0.14 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers73 claims73 services$15.68 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers70 claims70 services$6.49 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers16 claims16 services$205.70 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

12 suppliers183 claims183 services$21.91 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

MAX-MED CLINIC, INC

Specialist

2698 SW 87TH AVE
MIAMI, FL 33165

Miami-Dade County (305) 461-4417

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 Fernando Esparza's NPI number?

The NPI number for Fernando Esparza is 1083651178. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Where is Fernando Esparza located?

Fernando Esparza practices at 2698 SW 87th Ave, Miami, FL 33165. The listed phone number is (305) 461-4417.

What is Fernando Esparza's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Fernando Esparza enrolled in Medicare?

Yes. Fernando Esparza 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 Fernando Esparza accept?

Health plans from Ambetter Health and Ambetter of Alabama list Fernando Esparza 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.

When was this NPI record last updated?

The NPPES record for Fernando Esparza was last updated on February 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.