ALBERTO PINZON ARDILA MD
NPI 1154643120
Psychiatry & Neurology - Epilepsy in Miami, FL

Q: What is Alberto Pinzon Ardila's NPI number?

The NPI number for Alberto Pinzon Ardila is 1154643120. It was assigned to this individual provider in the NPPES registry on February 18, 2010.

Q: What is Alberto Pinzon Ardila's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Epilepsy, with taxonomy code 2084E0001X.

Active since February 18, 2010PECOS EnrolledAccepts Medicare Assignment

76.22/100

CMS Quality Rating

9055 SW 87TH AVE STE 100, MIAMI, FL 33176(305) 596-2080(305) 351-7905 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 5, 2025, Jun 12, 2025, Dec 18, 2019 and 1 more (4 updates tracked since 2016).

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About Alberto Pinzon Ardila Md NPPES

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

ALBERTO PINZON ARDILA MD (NPI 1154643120) is an individual epilepsy provider in Miami, Florida, licensed in Florida (ME104275) and active in the NPI registry since February 2010. He is enrolled in Medicare PECOS, is affiliated with Baptist Hospital Of Miami, and maintains a secondary practice location in Kansas City.

NPPES Registry Identity

NPI1154643120

Entity TypeIndividualMale

Primary Taxonomy2084E0001X

Provider Legal NameALBERTO PINZON ARDILACredential: MD

Location Address9055 SW 87TH AVE STE 100Miami, FL 33176-2306

Mailing AddressPo Box 160010Hialeah, FL 33016-0001 · (786) 924-1311 · Fax (786) 924-1313

Phone(305) 596-2080

Fax(305) 351-7905

Sole ProprietorYes

Medical School CMSOtherGraduated 2004

Enumeration DateFebruary 18, 2010

Last NPPES UpdateDecember 5, 20254 updates tracked since enumeration

NPPES CertifiedDecember 5, 2025

✔ NPI 1154643120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · EpilepsyAllopathic & Osteopathic Physicians

Taxonomy Code2084E0001X

Licenses✔ Licensed in FL · ME104275✔ Licensed in MO · 2025049644

Definition

Epilepsy is a subspecialty of neurology focused on the diagnosis and treatment of patients with epilepsy, including new-onset, medically refractory epilepsy, psychogenic nonepileptic seizures, and epilepsy in special populations (the elderly, women, patients with co-morbidities). Epilepsy is a multidisciplinary field that provides comprehensive care of the patient.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License ME104275 (FL)

9055 SW 87TH AVE STE 100, Miami, FL 33176

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Secondary Practice Location 1

Location 14400 Broadway Blvd Ste 520Kansas City, MO 64111-3342 · Phone (816) 960-7600 · Fax (816) 960-7699

Other Identifiers 1

OtherME104275FL · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Anthem Blue Cross and Blue Shield, AvMed 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

Alberto Pinzon Ardila 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 ID3072700210

PECOS Enrollment IDI20101214000375, I20251215001280, I20260514000184

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 Alberto Pinzon Ardila reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Neuroscience Consultants LLP

13 mi

Specialist

9960 NW 116 WAY, SUITE 13
Medley, FL 33178

Reassigned Medicare billing, Florida enrollment
140 clinicians in this Medicare group

NPI 1346217452 (786) 924-1311

Saint Luke's Physician Group Inc

1,224 mi

Infusion Therapy

600 NE ADAMS DAIRY PKWY
Blue Springs, MO 64014

Reassigned Medicare billing, Kansas and Missouri enrollments
Medicare enrollment name: Saint Lukes Physician Group Inc
845 clinicians in this Medicare group

NPI 1376257220 (816) 932-4630

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 15

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.

495 services183 patients

Measurement of brain wave activity (eeg), awake and asleep 95819

The measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.

181 services159 patients

Measurement of brain wave activity with video (veeg), 12-26 hours with review and report by health care professional 95720

This procedure monitors brain wave activity over 12-26 hours using Video EEG (VEEG). It involves recording brain waves and video to detect irregularities. A healthcare professional will review the data and provide a report. It's non-invasive and safe.

132 services50 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

93 services88 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

35 services35 patients

Measurement of brain wave activity (eeg), continuous 95700

Measurement of brain wave activity, or EEG, is a non-invasive procedure that records electrical patterns in your brain. This continuous monitoring helps to identify irregularities in brain function, aiding in diagnosis of conditions like epilepsy.

29 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

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.

23 services18 patients

Measurement of brain wave activity with video (veeg), 12-26 hours with intermittent monitoring 95715

This procedure involves recording your brain's electrical activity for 12-26 hours using electrodes attached to your scalp. It's paired with video monitoring to observe behavior during potential seizures or other neurological events. It's safe and non-invasive.

21 services13 patients

Measurement of brain wave activity with video (veeg), 12-26 hours with review and report by health care professional 95720

21 services13 patients

Measurement of brain wave activity (eeg), awake and drowsy 95816

Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.

20 services20 patients

Measurement of brain wave activity with video (veeg), 2-12 hours with continuous monitoring 95713

This procedure, called Video EEG, monitors brain wave activity for 2-12 hours. It uses video to track physical behaviors while EEG records brain activity. It helps in diagnosing conditions like seizures, sleep disorders, or unexplained behavior changes.

16 services16 patients

Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional 95718

This procedure, known as a Video EEG (VEEG), records brain wave activity for 2-12 hours. It involves attaching electrodes to your scalp and monitoring brain waves while a video records your actions. This helps health professionals understand and diagnose neurological issues.

16 services16 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.

14 services14 patients

Measurement of brain wave activity (eeg), awake and drowsy 95816

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Hospital Of Miami

Acute Care Hospitals · Miami, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100008

Location8900 N Kendall DrMiami, FL 33176 · Miami-Dade County

Emergency services Birthing friendly

Homestead Hospital

Acute Care Hospitals · Homestead, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100125

Location975 Baptist WayHomestead, FL 33033 · Miami-Dade County

Emergency services Birthing friendly

West Kendall Baptist Hospital

Acute Care Hospitals · Miami, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100314

Location9555 SW 162 AveMiami, FL 33196 · Miami-Dade County

Emergency services Birthing friendly

Fishermen's Community Hospital

Critical Access Hospitals · Marathon, FL

OwnershipVoluntary non-profit - Private

CMS Certification Number101312

Location3301 Overseas HwyMarathon, FL 33050 · Monroe County

Emergency services

St Lukes Hospital Of Kansas City

Acute Care Hospitals · Kansas City, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260138

Location4401 Wornall RoadKansas City, MO 64111 · Jackson County

Emergency services Birthing friendly

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.

76.22/100

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

Scored as part of a group practice

Quality

62.74

Promoting Interoperability

Improvement Activities

Cost

54.18

Referred Medical Equipment & Supplies CMS DME claims

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

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers16 claims16 services$36.93 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 11

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

DR. ALLAN HERSKOWITZ M.D.

Psychiatry & Neurology (Neurology)