RAUL A MARQUEZ MD
NPI 1164434320
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Edinburg, TX

Q: What is Raul Marquez's NPI number?

The NPI number for Raul Marquez is 1164434320. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Q: What is Raul Marquez's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Raul Marquez was last updated on February 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 August 13, 2006PECOS EnrolledAccepts Medicare Assignment

2402 CORNERSTONE BLVD, EDINBURG, TX 78539(956) 668-0060(956) 971-8809 Get Directions Write a Review

NPPES record last updated: February 5, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Raul A Marquez Md NPPES

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

RAUL A MARQUEZ MD (NPI 1164434320) is an individual adult reconstructive orthopaedic surgery provider in Edinburg, Texas, licensed in Texas (J1302) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1164434320

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameRAUL A MARQUEZCredential: MD

Location Address2402 CORNERSTONE BLVDEdinburg, TX 78539-8462

Mailing Address2402 Cornerstone BlvdEdinburg, TX 78539-8462 · (956) 668-0060 · Fax (956) 668-0070

Phone(956) 668-0060

Fax(956) 971-8809

Sole ProprietorNo

Medical School CMSOtherGraduated 1980

Enumeration DateAugust 13, 2006

Last NPPES UpdateFebruary 5, 2016

✔ NPI 1164434320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in TX · J1302

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

2402 CORNERSTONE BLVD, Edinburg, TX 78539

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Other Identifiers 3

Medicaid084243701TX

Medicare UPIND46955TX

Medicare PIN87W340TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Raul A Marquez 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 ID1254249287

PECOS Enrollment IDI20100503000387

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 Raul Marquez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Raul A. Marquez, MD PA

Same address

Adult Reconstructive Orthopaedic Surgery

2402 CORNERSTONE BLVD
Edinburg, TX 78539

Reassigned Medicare billing, Texas enrollment
7 clinicians in this Medicare group

NPI 1366557548 (956) 668-0060

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 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.

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

98 services69 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

54 services41 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

45 services43 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.

42 services42 patients

Computer-assisted surgery for muscle and bone procedure 20985

Computer-assisted surgery for muscle and bone procedures involves using a computer to aid in planning and performing surgery. This technology helps increase precision, reduce invasiveness, and improve outcomes. It's commonly used in orthopedic surgeries like joint replacements.

38 services36 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.

37 services35 patients

Hospital Affiliations CMS Care Compare 3

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450119

Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Cornerstone Regional Hospital

Acute Care Hospitals · Edinburg, TX

OwnershipProprietary

CMS Certification Number450825

Location2302 Cornerstone BoulevardEdinburg, TX 78539 · Hidalgo County

Emergency services

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipPhysician

CMS Certification Number450869

Location5501 South MccollEdinburg, TX 78539 · Hidalgo 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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

81%1,819 patients3/55-star benchmark: 100%

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.

85%115 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

71%531 patients3/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

96%342 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.

95%508 patients4/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

87%1,325 patients4/55-star benchmark: 97%

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…

82%508 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…

0%508 patients1/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 531 patients

0%531 patients5/55-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.

Other Providers at the Same Location NPPES 10

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

RYAN LEE REYNA DPT

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