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ERIKA PINTO PA-C
NPI 1164977013
Physician Assistant in Berlin, MD

Active since August 22, 2016PECOS EnrolledAccepts Medicare Assignment
79.47/100
CMS Quality Rating
11103 CATHAGE RD, BERLIN, MD 21811(410) 912-6021 Get Directions Write a Review

NPPES record last updated: February 16, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 16, 2021, Aug 22, 2016 (2 updates tracked since 2016).

About Erika Pinto Pa-c NPPES

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

ERIKA PINTO PA-C (NPI 1164977013) is an individual physician assistant in Berlin, Maryland, licensed in Maryland (C0006195) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1164977013
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameERIKA PINTOCredential: PA-C
Location Address11103 CATHAGE RDBerlin, MD 21811-2114
Mailing Address100 E Carroll StSalisbury, MD 21801-5422 · (410) 546-6400
Phone(410) 912-6021
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 22, 2016
Last NPPES UpdateFebruary 16, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 16, 2021
✔ NPI 1164977013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MD · C0006195
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
11103 CATHAGE RD, Berlin, MD 21811
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Other Names 1

Former Name (1)Erika Anders

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

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

Erika Pinto Pa-c 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 ID2567740558
PECOS Enrollment IDI20161026000537
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 7

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 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.
361 services314 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.
283 services227 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
76 services76 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
68 services68 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.
28 services28 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Tidalhealth Peninsula Regional, Inc

Acute Care Hospitals · Salisbury, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210019
Location100 East Carroll AvenueSalisbury, MD 21801 · Wicomico County
Emergency services Birthing friendly

Atlantic General Hospital

Acute Care Hospitals · Berlin, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210061
Location9733 Healthway DriveBerlin, MD 21811 · Worcester County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21811 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
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.

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.

79.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.23
Promoting Interoperability92
Improvement Activities40
Cost60

Other Providers at the Same Location NPPES 4

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

TIDALHEALTH SPECIALTY CARE, LLC
Internal Medicine (Gastroenterology)
11103 CATHAGE RD
BERLIN, MD 21811
Worcester County (410) 641-2938
ANESTHESIA COMPANY, LLC
Anesthesiology
11103 CATHAGE RD
BERLIN, MD 21811
Worcester County (410) 677-6654
DELMARVA ENDOSCOPY CENTER LLC
Clinic/Center (Ambulatory Surgical)
11103 CATHAGE RD
BERLIN, MD 21811
Worcester County (410) 847-7900
MID ATLANTIC SURGICAL GROUP
Surgery
11103 CATHAGE RD
BERLIN, MD 21811
Worcester County (410) 543-9332

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 Erika Pinto's NPI number?

The NPI number for Erika Pinto is 1164977013. It was assigned to this individual provider in the NPPES registry on August 22, 2016. The provider is also known as Erika Anders.

Where is Erika Pinto located?

Erika Pinto practices at 11103 Cathage Rd, Berlin, MD 21811. The listed phone number is (410) 912-6021.

What is Erika Pinto's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Erika Pinto enrolled in Medicare?

Yes. Erika Pinto 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.

What insurance does Erika Pinto accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Erika Pinto 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.

Is Erika Pinto affiliated with any hospitals?

According to CMS data, Erika Pinto is affiliated with Tidalhealth Peninsula Regional, Inc and Atlantic General Hospital.

When was this NPI record last updated?

The NPPES record for Erika Pinto was last updated on February 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.