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DANIEL ESPINOSA
NPI 1235585381
Family Medicine in Victoria, TX

Active since May 08, 2016PECOS EnrolledAccepts Medicare Assignment
86.37/100
CMS Quality Rating
605 E SAN ANTONIO ST STE 330E, VICTORIA, TX 77901(361) 576-9386(361) 576-9502 Get Directions Write a Review

NPPES record last updated: March 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Daniel Espinosa NPPES

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

DANIEL ESPINOSA (NPI 1235585381) is an individual family medicine provider in Victoria, Texas, licensed in Texas (650499) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Citizens Medical Center, and maintains a secondary practice location in Victoria.

NPPES Registry Identity

NPI1235585381
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDANIEL ESPINOSA
Location Address605 E SAN ANTONIO ST STE 330EVictoria, TX 77901-6028
Mailing Address601 E San Antonio St Ste 102wVictoria, TX 77901-6051 · (361) 582-0861
Phone(361) 576-9386
Fax(361) 576-9502
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMay 8, 2016
Last NPPES UpdateMarch 10, 2021
NPPES CertifiedMarch 10, 2021
✔ NPI 1235585381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · 650499
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
605 E SAN ANTONIO ST STE 330E, Victoria, TX 77901
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Secondary Practice Location 1

Location 1601 E San Antonio St Ste 102WVictoria, TX 77901-6051 · Phone (361) 582-0861

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

Daniel Espinosa 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 ID4183956949
PECOS Enrollment IDI20191028001426
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 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.
326 services124 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.
138 services92 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
94 services94 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
31 services31 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.
29 services29 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.
28 services28 patients

Hospital Affiliations CMS Care Compare 4

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

Citizens Medical Center

Acute Care Hospitals · Victoria, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450023
Location2701 Hospital DriveVictoria, TX 77901 · Victoria County
Emergency services Birthing friendly

De Tar Hospital Navarro

Acute Care Hospitals · Victoria, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450147
Location506 E San Antonio StVictoria, TX 77901 · Victoria County
Emergency services Birthing friendly

Baylor Medical Center At Trophy Club

Acute Care Hospitals · Trophy Club, TX
OwnershipProprietary
CMS Certification Number450883
Location2850 E State Highway 114Trophy Club, TX 76262 · Denton County
Emergency services

Jackson Healthcare Center

Critical Access Hospitals · Edna, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451363
Location1013 S WellsEdna, TX 77957 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77901 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
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.

86.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality72.75
Promoting Interoperability100
Improvement Activities40

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 Daniel Espinosa's NPI number?

The NPI number for Daniel Espinosa is 1235585381. It was assigned to this individual provider in the NPPES registry on May 8, 2016.

Where is Daniel Espinosa located?

Daniel Espinosa practices at 605 E San Antonio St Ste 330E, Victoria, TX 77901. The listed phone number is (361) 576-9386.

What is Daniel Espinosa's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Daniel Espinosa enrolled in Medicare?

Yes. Daniel Espinosa 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 Daniel Espinosa 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 3 other insurers list Daniel Espinosa 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 Daniel Espinosa affiliated with any hospitals?

According to CMS data, Daniel Espinosa is affiliated with Citizens Medical Center, De Tar Hospital Navarro, Baylor Medical Center At Trophy Club and Jackson Healthcare Center.

When was this NPI record last updated?

The NPPES record for Daniel Espinosa was last updated on March 10, 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.