DR. ROY T AVALOS M.D.
NPI 1154399632
Internal Medicine - Cardiovascular Disease in Encinitas, CA

Q: What is Roy Avalos's NPI number?

The NPI number for Roy Avalos is 1154399632. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Q: What is Roy Avalos's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Roy Avalos was last updated on March 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 March 09, 2006PECOS EnrolledAccepts Medicare Assignment

320 SANTA FE DR, SUITE 204, ENCINITAS, CA 92024(760) 944-7300(760) 634-6564 Get Directions Write a Review

NPPES record last updated: March 9, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Roy T Avalos M.d. NPPES

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

DR. ROY T AVALOS M.D. (NPI 1154399632) is an individual cardiovascular disease provider in Encinitas, California, licensed in California (A68893) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (1997).

NPPES Registry Identity

NPI1154399632

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. ROY T AVALOSCredential: M.D.

Location Address320 SANTA FE DR, SUITE 204Encinitas, CA 92024-5138

Mailing Address320 Santa Fe Dr, Ste 204Encinitas, CA 92024-5179 · (760) 944-7300 · Fax (760) 634-6564

Phone(760) 944-7300

Fax(760) 634-6564

Sole ProprietorNo

Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 1997

Enumeration DateMarch 9, 2006

Last NPPES UpdateMarch 9, 2017

✔ NPI 1154399632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in CA · A68893

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

320 SANTA FE DR, Encinitas, CA 92024

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Other Identifiers 2

Medicare UPINI11988CA

Medicare ID-Type UnspecifiedWA68893ACA · Ppin#

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

Dr. Roy T Avalos 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 ID7214900265

PECOS Enrollment IDI20040817001152

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

Medicare enrollment records show Roy Avalos reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

San Diego Cardiovascular Associates Medical Group Inc

Same address

Cardiovascular Disease

320 SANTA FE DR, SUITE 204
Encinitas, CA 92024

Reassigned Medicare billing, California enrollment
15 clinicians in this Medicare group

NPI 1427069103 (760) 944-7300

Scripps Health

0.2 mi

General Acute Care Hospital

354 SANTA FE DR
Encinitas, CA 92024

Reassigned Medicare billing, California enrollment
1,598 clinicians in this Medicare group

NPI 1700829199 (760) 457-4123

Scripps Cardiology Medical Group, Inc.

11 mi

Cardiovascular Disease

9888 GENESEE AVE
La Jolla, CA 92037

Reassigned Medicare billing, California enrollment
19 clinicians in this Medicare group

NPI 1851481121 (858) 824-2900

Emergency And Acute Care Medical Corporation

18 mi

Emergency Medicine

7901 FROST ST
San Diego, CA 92123

Reassigned Medicare billing, California enrollment
1,437 clinicians in this Medicare group

NPI 1437103942 (858) 939-3400

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 37

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 high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

788 services542 patients

Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502

Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.

698 services346 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

632 services156 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

426 services420 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

379 services208 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

357 services354 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

352 services349 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

282 services278 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

191 services187 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

153 services20 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

153 services18 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

142 services20 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

117 services19 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

97 services17 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

86 services12 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

83 services79 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

77 services69 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.

73 services73 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

71 services69 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

62 services61 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

52 services52 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

50 services43 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

50 services46 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

48 services43 patients

Drug infusion during cardiac catheterization 93463

Drug infusion during cardiac catheterization involves delivering medication directly to your heart via a thin tube. This process helps to diagnose or treat heart conditions by improving blood flow or assessing heart function. It's a safe, common procedure.

44 services43 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

43 services42 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

41 services32 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

39 services39 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

39 services39 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

38 services36 patients

Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional 93229

An Electrocardiogram (ECG) is a test that records your heart's electrical activity for up to 30 days. You trigger a transmission if you feel symptoms, which is then reviewed by a healthcare professional. The report helps diagnose heart conditions.

29 services29 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

27 services27 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

23 services21 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system 93288

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

20 services16 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

18 services16 patients

Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel 92941

This procedure involves removing plaque, a substance that can block your blood vessels, and any blood clots. A stent, a tiny tube, may be inserted to keep the vessel open. If necessary, a balloon is inflated to widen the vessel, aiding blood flow.

15 services15 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92024 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

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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.

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.

MS. ANNE LOUISE BURNS NP

Nurse Practitioner

320 SANTA FE DR, SUITE 204
ENCINITAS, CA 92024

San Diego County (760) 944-7300

MR. JOHN WAYNE COWAN P.A.

Physician Assistant

320 SANTA FE DR, STE. 300
ENCINITAS, CA 92024

San Diego County (760) 753-5667

DR. LAWRENCE DAVID EISENHAUER MD

Specialist

320 SANTA FE DR, STE LL4
ENCINITAS, CA 92024

San Diego County (760) 753-8413

WILLIAM L. HEIMER II, M.D., APC

Specialist

320 SANTA FE DR, SUITE 310
ENCINITAS, CA 92024

San Diego County (760) 944-7000

INTEGRATED DERMATOLOGY OF ENCINITAS, PC

Dermatology

320 SANTA FE DR, SUITE 310
ENCINITAS, CA 92024

San Diego County (760) 944-7000

CHECK POINT TRANSITION CLINIC, INC.

Internal Medicine

320 SANTA FE DR, SUITE 308
ENCINITAS, CA 92024

San Diego County (760) 230-8994

GARRETT J TALLMAN MD INC

Orthopaedic Surgery

320 SANTA FE DR, 301
ENCINITAS, CA 92024

San Diego County (760) 633-4700

SUNIL S. RAYAN M.D.

Surgery (Vascular Surgery)

320 SANTA FE DR, STE 212
ENCINITAS, CA 92024

San Diego County (760) 943-0101

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 Roy Avalos's NPI number?

The NPI number for Roy Avalos is 1154399632. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Where is Roy Avalos located?

Roy Avalos practices at 320 Santa Fe Dr Suite 204, Encinitas, CA 92024. The listed phone number is (760) 944-7300.

What is Roy Avalos's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Roy Avalos enrolled in Medicare?

Yes. Roy Avalos 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 Roy Avalos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roy Avalos reassigns Medicare benefits to 4 organizations: San Diego Cardiovascular Associates Medical Group Inc (Encinitas, CA), Scripps Health (Encinitas, CA), Scripps Cardiology Medical Group, Inc. (La Jolla, CA) and Emergency And Acute Care Medical Corporation (San Diego, CA). 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 Roy Avalos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roy Avalos was last updated on March 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.