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AVELINA FERNANDO FLORES MD
NPI 1104899582
Internal Medicine in Lanoka Harbor, NJ

Active since February 08, 2006PECOS Enrolled
411 RTE 9, STE 6, LANOKA HARBOR, NJ 08734(609) 971-1711(609) 971-3390 Get Directions Write a Review

NPPES record last updated: February 9, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Avelina Fernando Flores Md NPPES

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

AVELINA FERNANDO FLORES MD (NPI 1104899582) is an individual internal medicine provider in Lanoka Harbor, New Jersey, licensed in New Jersey (MA033641) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104899582
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameAVELINA FERNANDO FLORESCredential: MD
Location Address411 RTE 9, STE 6Lanoka Harbor, NJ 08734
Mailing Address411 Rt9, Suite 6Lanoka Harbor, NJ 08734 · (609) 971-1711 · Fax (609) 971-3390
Phone(609) 971-1711
Fax(609) 971-3390
Sole ProprietorNo
Enumeration DateFebruary 8, 2006
Last NPPES UpdateFebruary 9, 2012
✔ NPI 1104899582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · MA033641
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.
411 RTE 9, Lanoka Harbor, NJ 08734
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Other Names 1

Professional Name (2)Avelina Fernando Flores Md

Other Identifiers 1

Medicare UPINE75331

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avelina Fernando Flores Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Avelina Flores reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Manish Saini MD LLC
6.3 mi
Internal Medicine
1163 RTE 37 W, SUITE B1
Toms River, NJ 08755
  • Reassigned Medicare billing, New Jersey enrollment
  • 7 clinicians in this Medicare group
NPI 1699960674 (732) 341-7900

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

Areas of Expertise CMS Part B claims 9

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.

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.
361 services126 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.
187 services65 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
55 services55 patients
Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes 99423
This service involves a week-long digital assessment and management program for existing patients. It includes continuous health monitoring, virtual consultations, and personalized treatment plans. The total time spent is 21 minutes or more, ensuring comprehensive care.
33 services25 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.
33 services33 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
24 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08734 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%406 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
93%353 patients4/55-star benchmark: 99%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
81%353 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%353 patients1/55-star benchmark: 59%
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 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers33 claims81 services$5.78 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers27 claims31 services$0.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Avelina Flores's NPI number?

The NPI number for Avelina Flores is 1104899582. It was assigned to this individual provider in the NPPES registry on February 8, 2006. The provider is also known as Avelina Fernando Flores MD.

Where is Avelina Flores located?

Avelina Flores practices at 411 Rte 9 Ste 6, Lanoka Harbor, NJ 08734. The listed phone number is (609) 971-1711.

What is Avelina Flores's specialty?

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

Is Avelina Flores enrolled in Medicare?

Yes. Avelina Flores is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Avelina Flores's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Avelina Flores reassigns Medicare benefits to Manish Saini MD LLC (Toms River, NJ). The 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 Avelina Flores's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Avelina Flores accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Avelina Flores 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 Avelina Flores was last updated on February 9, 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.