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GILBERTO JIMENEZ MD
NPI 1083690366
Internal Medicine in Hialeah, FL

Active since December 19, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 10D2074342 · Waiver
1435 W 49TH PL STE 306, HIALEAH, FL 33012(305) 364-9949(305) 364-0927 Get Directions Write a Review

NPPES record last updated: November 18, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Gilberto Jimenez Md NPPES

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

GILBERTO JIMENEZ MD (NPI 1083690366) is an individual internal medicine provider in Hialeah, Florida, licensed in Florida (M82228) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through March 5, 2028, and is affiliated with Larkin Community Hospital Palm Springs Campus.

NPPES Registry Identity

NPI1083690366
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameGILBERTO JIMENEZCredential: MD
Location Address1435 W 49TH PL STE 306Hialeah, FL 33012-3147
Mailing Address19346 Sw 41st StMiramar, FL 33029-2752 · (954) 430-0838 · Fax (954) 430-0838
Phone(305) 364-9949
Fax(305) 364-0927
Sole ProprietorNo
Medical School CMSOtherGraduated 1976
Enumeration DateDecember 19, 2005
Last NPPES UpdateNovember 18, 2020
NPPES CertifiedNovember 18, 2020
✔ NPI 1083690366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · M82228
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1435 W 49TH PL STE 306, Hialeah, FL 33012
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gilberto Jimenez 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 ID8729981071
PECOS Enrollment IDI20040202000695
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.

Medicare Billing Reassignments

5

Medicare enrollment records show Gilberto Jimenez reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gilberto Jimenez MD Inc
Same address
Internal Medicine
1435 W 49TH PL STE 306
Hialeah, FL 33012
  • Reassigned Medicare billing, Florida enrollment
NPI 1871549840 (305) 364-9949
Behavioral For Kids Corp
3.2 mi
Community/Behavioral Health
5729 NW 151ST ST STE B
Miami Lakes, FL 33014
  • Reassigned Medicare billing, Florida enrollment
NPI 1376072769 (786) 360-2655
Qmc LLC
6.1 mi
Hospitalist
5201 BLUE LAGOON DR FL 89
Miami, FL 33126
  • Reassigned Medicare billing, Florida enrollment
  • 183 clinicians in this Medicare group
NPI 1003216391 (305) 554-1700
Florida Hospital Medicine Services, LLC.
54 mi
Hospitalist
21644 STATE ROAD 7
Boca Raton, FL 33428
  • Reassigned Medicare billing, Florida enrollment
  • 516 clinicians in this Medicare group
NPI 1508873183 (561) 488-8000
Inpatient Consultants Of Florida Inc
201 mi
Hospitalist
3550 BUSCHWOOD PARK DR, SUITE 350
Tampa, FL 33618
  • Reassigned Medicare billing, Florida enrollment
  • 903 clinicians in this Medicare group
NPI 1457511164 (813) 936-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2074342

Gilberto Jimenez MD · Hialeah, FL
Active · expires Mar 5, 2028
CLIA Number10D2074342
Laboratory TypePhysician Office
Certificate Effective DateMarch 6, 2026
Certificate Expiration DateMarch 5, 2028
Laboratory DirectorGilbert Jimenez
Laboratory Phone(305) 364-9949
Laboratory LocationGilberto Jimenez MD1435 W 49th Pl Ste 306 Medical Plaza Bldg, Hialeah, FL 33012
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

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 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.
318 services76 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.
191 services41 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.
150 services67 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.
25 services25 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.
22 services14 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
20 services13 patients

Hospital Affiliations CMS Care Compare

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

Larkin Community Hospital Palm Springs Campus

Acute Care Hospitals · Hialeah, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100050
Location1475 W 49th StHialeah, FL 33012 · Miami-Dade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33012 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 22

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 supplier24 claims48 services$0.44 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers115 claims395 services$6.66 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
1 supplier53 claims53 services$2.94 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
1 supplier16 claims16 services$1.83 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers75 claims158 services$1.19 avg. paid by Medicare
Oropharyngeal suction catheter, each A4628
DME-Other DME · category DE000N
1 supplier14 claims80 services$3.31 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.

GILBERTO JIMENEZ MD INC
Internal Medicine
1435 W 49TH PL STE 306
HIALEAH, FL 33012
Miami-Dade County (305) 364-9949

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 Gilberto Jimenez's NPI number?

The NPI number for Gilberto Jimenez is 1083690366. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Where is Gilberto Jimenez located?

Gilberto Jimenez practices at 1435 W 49th Pl Ste 306, Hialeah, FL 33012. The listed phone number is (305) 364-9949.

What is Gilberto Jimenez's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Gilberto Jimenez enrolled in Medicare?

Yes. Gilberto Jimenez 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.

Which organizations bill Medicare for Gilberto Jimenez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gilberto Jimenez reassigns Medicare benefits to 5 organizations: Gilberto Jimenez MD Inc (Hialeah, FL), Behavioral For Kids Corp (Miami Lakes, FL), Qmc LLC (Miami, FL), Florida Hospital Medicine Services, LLC. (Boca Raton, FL) and Inpatient Consultants Of Florida Inc (Tampa, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gilberto Jimenez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Does Gilberto Jimenez hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2074342) is associated with this NPI, valid through March 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Gilberto Jimenez accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health, Oscar Health Maintenance Organization of Florida and Oscar Insurance Company and 1 other insurer list Gilberto Jimenez 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 Gilberto Jimenez affiliated with any hospitals?

According to CMS data, Gilberto Jimenez is affiliated with Larkin Community Hospital Palm Springs Campus.

When was this NPI record last updated?

The NPPES record for Gilberto Jimenez was last updated on November 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.