1. Home
  2. Directory
  3. Texas
  4. Brownsville
  5. Internal Medicine
  6. NPI Profile

ROBERTO PONCE MD
NPI 1174529291
Internal Medicine - Gastroenterology in Brownsville, TX

Active since June 23, 2005PECOS EnrolledAccepts Medicare Assignment
2449 BOCA CHICA BLVD, STE B, BROWNSVILLE, TX 78521(956) 542-1531(956) 542-0028 Get Directions Write a Review

NPPES record last updated: July 31, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 31, 2018, Mar 16, 2017 (2 updates tracked since 2017).

About Roberto Ponce Md NPPES

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

ROBERTO PONCE MD (NPI 1174529291) is an individual gastroenterology provider in Brownsville, Texas, licensed in Texas (F3582) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Valley Baptist Medical Center- Brownsville, and is a graduate of Other (1969).

NPPES Registry Identity

NPI1174529291
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameROBERTO PONCECredential: MD
Location Address2449 BOCA CHICA BLVD, STE BBrownsville, TX 78521-2368
Mailing Address2449 Boca Chica Blvd, Ste BBrownsville, TX 78521-2368 · (956) 542-1531 · Fax (956) 542-0028
Phone(956) 542-1531
Fax(956) 542-0028
Sole ProprietorYes
Medical School CMSOtherGraduated 1969
Enumeration DateJune 23, 2005
Last NPPES UpdateJuly 31, 20182 updates tracked since enumeration
✔ NPI 1174529291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in TX · F3582
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedSpecialistTaxonomy 174400000X · License F3582 (TX)
2449 BOCA CHICA BLVD, Brownsville, TX 78521
Open in Google Maps ↗

Other Identifiers 2

Medicaid110414301TX
Other88460FTX · Gastroenterology

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roberto Ponce 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 ID345348686
PECOS Enrollment IDI20110421000587
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 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.

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.
63 services48 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
61 services58 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.
52 services50 patients
Diagnostic exam of large bowel using a flexible endoscope 45378
This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
46 services44 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.
33 services33 patients
Insertion of stomach tube using a flexible endoscope 43246
This procedure involves the use of a flexible endoscope, a thin tube with a light and camera, to insert a stomach tube. It helps doctors view and access your stomach without surgery. It's typically performed under sedation to ensure comfort.
28 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Valley Baptist Medical Center- Brownsville

Acute Care Hospitals · Brownsville, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450028
Location1040 W Jefferson StBrownsville, TX 78520 · Cameron County
Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450662
Location100 A Alton GloorBrownsville, TX 78526 · Cameron County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78521 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
89%406 patients5/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
68%157 patients3/55-star benchmark: 99%
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.
100%806 patients5/55-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.
98%63 patients4/55-star benchmark: 100%
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.
92%418 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.
100%321 patients5/55-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…
96%626 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…
95%321 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…
2%321 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% · 356 patients
1%356 patients4/55-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.

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 Roberto Ponce's NPI number?

The NPI number for Roberto Ponce is 1174529291. It was assigned to this individual provider in the NPPES registry on June 23, 2005.

Where is Roberto Ponce located?

Roberto Ponce practices at 2449 Boca Chica Blvd Ste B, Brownsville, TX 78521. The listed phone number is (956) 542-1531.

What is Roberto Ponce's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Roberto Ponce enrolled in Medicare?

Yes. Roberto Ponce 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 Roberto Ponce accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 6 other insurers list Roberto Ponce 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 Roberto Ponce affiliated with any hospitals?

According to CMS data, Roberto Ponce is affiliated with Valley Baptist Medical Center- Brownsville and Valley Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Roberto Ponce was last updated on July 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.