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MICHAEL SEPULVEDA MD
NPI 1164425757
Internal Medicine in San Juan Bautista, CA

Active since May 27, 2005PECOS EnrolledAccepts Medicare Assignment
342 VIA VAQUERO SUR, SAN JUAN BAUTISTA, CA 95045(831) 325-6459 Get Directions Write a Review

NPPES record last updated: March 24, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Michael Sepulveda Md NPPES

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

MICHAEL SEPULVEDA MD (NPI 1164425757) is an individual internal medicine provider in San Juan Bautista, California, licensed in California (A64123) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (1996).

NPPES Registry Identity

NPI1164425757
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMICHAEL SEPULVEDACredential: MD
Location Address342 VIA VAQUERO SURSan Juan Bautista, CA 95045-9307
Mailing Address342 Via Vaquero SurSan Juan Bautista, CA 95045-9307 · (831) 325-6459
Phone(831) 325-6459
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1996
Enumeration DateMay 27, 2005
Last NPPES UpdateMarch 24, 2015
✔ NPI 1164425757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A64123
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.
Also ListedSpecialistTaxonomy 174400000X · License A64123 (CA)
342 VIA VAQUERO SUR, San Juan Bautista, CA 95045
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Other Identifiers 1

Medicare UPINH52317CA

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

Michael Sepulveda 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 ID648265876
PECOS Enrollment IDI20040417000231
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 2

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.

Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
26 services26 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.
17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95045 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
$157.65 typical visit price
range $70.72 – $207.37
Typical copayment $39.41 (range $17.68 – $51.84)
Most-billed visit code 99204
Established Patient
$122.36 typical visit price
range $24.01 – $170.46
Typical copayment $30.59 (range $6.00 – $42.61)
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

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
56%48 patients3/55-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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$16.28 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
1 supplier11 claims11 services$76.60 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 Michael Sepulveda's NPI number?

The NPI number for Michael Sepulveda is 1164425757. It was assigned to this individual provider in the NPPES registry on May 27, 2005.

Where is Michael Sepulveda located?

Michael Sepulveda practices at 342 Via Vaquero Sur, San Juan Bautista, CA 95045. The listed phone number is (831) 325-6459.

What is Michael Sepulveda's specialty?

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

Is Michael Sepulveda enrolled in Medicare?

Yes. Michael Sepulveda 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.

When was this NPI record last updated?

The NPPES record for Michael Sepulveda was last updated on March 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.